Provider Demographics
NPI:1083732671
Name:FAITHFUL CENTRAL BIBLE CHURCH
Entity Type:Organization
Organization Name:FAITHFUL CENTRAL BIBLE CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PASTOR OF COUNSELING
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:POLITE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-330-8000
Mailing Address - Street 1:333 W FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301
Mailing Address - Country:US
Mailing Address - Phone:310-330-8000
Mailing Address - Fax:310-419-0041
Practice Address - Street 1:333 W FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1103
Practice Address - Country:US
Practice Address - Phone:310-330-8000
Practice Address - Fax:310-419-0041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health