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General NPI Number Information
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NPI Number | 1811848864
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Entity Type | Organization
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Legal Business Name | DIVINE HOLINESS OUTREACH MINISTRY
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 1109 E. 18TH STREET
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City | CARUTHERSVILLE
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State | MO
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Zip | 63830
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Country | US
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Telephone | 573-333-4099
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 903
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City | CARUTHERSVILLE
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State | MO
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Zip | 63830-0903
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | DEBORAH JONES
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Credential |
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Telephone | 573-333-4099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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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 | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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License Number State |
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