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General NPI Number Information
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NPI Number | 1720450075
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Entity Type | Organization
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Legal Business Name | THE TRUTH OUTREACH
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 185 CORNERSTONE DRIVE
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City | WEST UNION
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State | SC
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Zip | 29696
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Country | US
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Telephone | 864-275-1463
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Fax | 864-382-6545
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Provider Business Mailing Address
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Address Line | 185 CORNERSTONE DR
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City | WEST UNION
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State | SC
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Zip | 29696-2623
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Country | US
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Telephone | 864-275-1453
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Fax | 864-382-6545
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Authorized Official
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Title or Position | PASTOR
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Name | MARIA R DAVIS
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Credential | BACHELOR DEGREE
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Telephone | 864-275-1463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | SC
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