MEDICARE: HELP MINISTRY FELLOWSHIP Y.E.T

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	251S00000X	Community/Behavioral Health Agency	190707AN	CA

General Provider Information

NPI Number	:	1720377252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELP MINISTRY FELLOWSHIP Y.E.T

Provider Business Mailing Address
First Line	:	3756 SANTA ROSALIA DR STE 219
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-3616
Country	:	US
Telephone Number	:	323-299-4357
Fax Number	:	323-299-1089

Provider Business Practice Location Address
First Line	:	3756 SANTA ROSALIA DR STE 219
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-3616
Country	:	US
Telephone Number	:	323-299-4357
Fax Number	:	323-299-1089

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	TONYA L. GUILLORY
Credential	:	CCDC
Telephone Number	:	323-299-4357

Provider Enumeration Date	:	04/05/2011
Last Update Date	:	04/05/2011

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