Provider Demographics
NPI:1154640829
Name:SACRED BLESSINGS OUTREACH MINISTRY CHURCH
Entity Type:Organization
Organization Name:SACRED BLESSINGS OUTREACH MINISTRY CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LESSIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-361-3871
Mailing Address - Street 1:9082 GRANDVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-1720
Mailing Address - Country:US
Mailing Address - Phone:248-361-3871
Mailing Address - Fax:248-987-2320
Practice Address - Street 1:9082 GRANDVILLE AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-1720
Practice Address - Country:US
Practice Address - Phone:248-361-3871
Practice Address - Fax:248-987-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable