=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821438623
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INTERFAITH MINISTRIES FOR GREATER HOUSTON
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2013
-----------------------------------------------------
Last Update Date | 06/26/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3303 MAIN ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77002-9322
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-533-4900
-----------------------------------------------------
Fax | 713-800-5115
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3303 MAIN ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77002-9322
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-533-4900
-----------------------------------------------------
Fax | 713-800-5115
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF OPERATING OFFICER
-----------------------------------------------------
Name | MR. ANDREW H HOFFMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-533-4906
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332U00000X
-----------------------------------------------------
Taxonomy Name | Home Delivered Meals
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------