Provider Demographics
NPI:1245563626
Name:MIGHTY MASON OUTREACH MINISTRY CHURCH
Entity Type:Organization
Organization Name:MIGHTY MASON OUTREACH MINISTRY CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MUZAFFER
Authorized Official - Middle Name:
Authorized Official - Last Name:AL ZAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-222-1900
Mailing Address - Street 1:4722 JOHN R RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3555
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1799 E GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48211-3145
Practice Address - Country:US
Practice Address - Phone:586-222-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable