=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841444312
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INMATES OF NECCESSITY MINISTRIES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/11/2008
-----------------------------------------------------
Last Update Date | 11/11/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19200 EDGEFIELD ST
-----------------------------------------------------
City | GROSSE POINTE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48236-2000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-469-0632
-----------------------------------------------------
Fax | 313-926-6297
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19200 EDGEFIELD ST
-----------------------------------------------------
City | GROSSE POINTE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48236-2000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-469-0632
-----------------------------------------------------
Fax | 313-926-6297
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COUNSELOR
-----------------------------------------------------
Name | MR. KENNETH L. CONLEY SR.
-----------------------------------------------------
Credential | MA,LLP
-----------------------------------------------------
Telephone | 313-477-5612
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251V00000X
-----------------------------------------------------
Taxonomy Name | Voluntary or Charitable Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------