MEDICARE: NATIONAL ASSOC OF WOMEN IN MINISTRY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YP1600X	Pastoral Counselor
2	343900000X	Non-emergency Medical Transport (VAN)
3	320800000X	Mental Illness Community Based Residential Treatment Facility
4	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
5	320700000X	Physical Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1659602886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL ASSOC OF WOMEN IN MINISTRY

Provider Business Mailing Address
First Line	:	PO BOX 705
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33402-0705
Country	:	US
Telephone Number	:	561-598-8862
Fax Number	:

Provider Business Practice Location Address
First Line	:	808 PALM BEACH TRACE DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-1268
Country	:	US
Telephone Number	:	561-598-8862
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. VERNELL KING
Credential	:	MA-PSY
Telephone Number	:	561-598-8862

Provider Enumeration Date	:	01/28/2010
Last Update Date	:	01/28/2010

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