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General NPI Number Information
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NPI Number | 1881317659
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Entity Type | Organization
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Legal Business Name | DELIVERANCE CENTER OUTREACH MINISTRY FOR CHRIST
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 3090 NW 7TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311-7612
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Country | US
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Telephone | 954-807-8990
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 NW 4TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311-8570
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Country | US
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Telephone | 954-807-8990
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANDOLPH JONES
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Credential |
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Telephone | 954-807-8990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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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 | 104100000X
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Taxonomy Name | Social Worker
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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