MEDICARE: THE CHARIS HEALING MINISTRIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP1600X	Pastoral Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1083885511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CHARIS HEALING MINISTRIES

Provider Business Mailing Address
First Line	:	11776 W SAMPLE RD
Second Line	:	SUITE 104
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-3180
Country	:	US
Telephone Number	:	954-753-0467
Fax Number	:

Provider Business Practice Location Address
First Line	:	11776 W SAMPLE RD
Second Line	:	SUITE 104
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-3180
Country	:	US
Telephone Number	:	954-753-0467
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	PAUL J SCHWEINLER
Credential	:	MDIV
Telephone Number	:	954-753-0467

Provider Enumeration Date	:	03/12/2008
Last Update Date	:	03/12/2008

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Directions to “THE CHARIS HEALING MINISTRIES ” Practice Location

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