Provider Demographics
NPI:1003119843
Name:NATIONAL CHAPLAIN SERVICE
Entity Type:Organization
Organization Name:NATIONAL CHAPLAIN SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAPLAIN
Authorized Official - Prefix:DR
Authorized Official - First Name:BENNIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:OLIPHANT
Authorized Official - Suffix:SR
Authorized Official - Credentials:DMIN
Authorized Official - Phone:313-938-8310
Mailing Address - Street 1:457 N SYBALD ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-8638
Mailing Address - Country:US
Mailing Address - Phone:313-838-8310
Mailing Address - Fax:734-326-5922
Practice Address - Street 1:457 N SYBALD ST
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-8638
Practice Address - Country:US
Practice Address - Phone:313-838-8310
Practice Address - Fax:734-326-5922
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL CHAPLAIN SERVICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
No282N00000XHospitalsGeneral Acute Care Hospital