MEDICARE: CHRISTIAN EMPOWERMENT WORSHIP CENTER AND 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1245674639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIAN EMPOWERMENT WORSHIP CENTER AND MINISTRIES

Provider Business Mailing Address
First Line	:	2322 SILVER MAPLE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-2400
Country	:	US
Telephone Number	:	317-945-4981
Fax Number	:

Provider Business Practice Location Address
First Line	:	2322 SILVER MAPLE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-2400
Country	:	US
Telephone Number	:	317-945-4981
Fax Number	:

Authorized Official
Title or Position	:	BOARD TREASURER
Name	:	MR. TAYLOR SEALS III
Credential	:
Telephone Number	:	317-625-0492

Provider Enumeration Date	:	04/29/2013
Last Update Date	:	04/29/2013

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