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NPI Code Detail

MEDICARE: INTERNATIONAL MISSION CENTER CHURCH, INC.

MEDICARE: INTERNATIONAL MISSION CENTER CHURCH, INC.
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
1101YP1600XPastoral Counselor
2103G00000XClinical Neuropsychologist
3103TA0400XAddiction (Substance Use Disorder) Psychologist
4103TA0700XAdult Development & Aging Psychologist
5103TB0200XCognitive & Behavioral Psychologist
6103TP0814XPsychoanalysis Psychologist
7103TC1900XCounseling Psychologist
8103TC2200XClinical Child & Adolescent Psychologist
9103TP2701XGroup Psychotherapy Psychologist
10103TF0000XFamily Psychologist
11103TM1800XIntellectual & Developmental Disabilities Psychologist
12261QA0600XAdult Day Care Clinic/Center
13103TC0700XClinical PsychologistTX

General Provider Information

NPI Number : 1487738613
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERNATIONAL MISSION CENTER CHURCH, INC.
Provider Business Mailing Address
First Line : 807 E HANSON ST
Second Line :
City : CLEVELAND
State : TX
Zip : 77327-4622
Country : US
Telephone Number : 281-592-9222
Fax Number : 281-592-5041
Provider Business Practice Location Address
First Line : 807 E HANSON ST
Second Line :
City : CLEVELAND
State : TX
Zip : 77327-4622
Country : US
Telephone Number : 281-592-9222
Fax Number : 281-592-5041
Authorized Official
Title or Position : CEO
Name : DR. ARTHUR N OJIONUKA
Credential :
Telephone Number : 281-592-9222
Provider Enumeration Date : 10/24/2006
Last Update Date : 11/02/2020

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1851411839 — SHANNON ENID HOFFMAN LPTA
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1780705525 — MISS LISA ANN JONES MA CCC-SLP
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CLEVELAND, OH
44103-4622
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Directions to “INTERNATIONAL MISSION CENTER CHURCH, INC. ” Practice Location

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