Provider Demographics
NPI:1083859862
Name:HEAVENLY HANDS MINISTRY OUTREACH CHURCH
Entity Type:Organization
Organization Name:HEAVENLY HANDS MINISTRY OUTREACH CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-895-9112
Mailing Address - Street 1:2277 BROOKHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-1681
Mailing Address - Country:US
Mailing Address - Phone:734-895-9112
Mailing Address - Fax:
Practice Address - Street 1:2277 BROOKHAVEN RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-1681
Practice Address - Country:US
Practice Address - Phone:734-895-9112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable