Provider Demographics
NPI:1053510297
Name:THORMINC, THE HOUSE OF REFUGE MINISTRIES, INC
Entity Type:Organization
Organization Name:THORMINC, THE HOUSE OF REFUGE MINISTRIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:LAFAYE
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-536-8155
Mailing Address - Street 1:PO BOX 28338
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32226-8338
Mailing Address - Country:US
Mailing Address - Phone:904-354-2233
Mailing Address - Fax:
Practice Address - Street 1:2137 N LIBERTY ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206-3827
Practice Address - Country:US
Practice Address - Phone:904-354-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management