Provider Demographics
NPI:1073372025
Name:INTERNATIONAL RIVER OF LIFE CHRISTIAN CENTER
Entity Type:Organization
Organization Name:INTERNATIONAL RIVER OF LIFE CHRISTIAN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PASTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:EVERETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-375-7504
Mailing Address - Street 1:85-576 WAIANAE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-2637
Mailing Address - Country:US
Mailing Address - Phone:808-375-7504
Mailing Address - Fax:
Practice Address - Street 1:87-728 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-3271
Practice Address - Country:US
Practice Address - Phone:808-375-7504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution