Provider Demographics
NPI:1255829792
Name:JEHORAM CHRISTIAN OUTREACH MINISTRIES
Entity Type:Organization
Organization Name:JEHORAM CHRISTIAN OUTREACH MINISTRIES
Other - Org Name:BALANCELIFE A DIVISION OF JCOM
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CHC
Authorized Official - Phone:682-551-0568
Mailing Address - Street 1:PO BOX 40345
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76140-0345
Mailing Address - Country:US
Mailing Address - Phone:817-688-7495
Mailing Address - Fax:
Practice Address - Street 1:3320 CHALMETTE CT
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:TX
Practice Address - Zip Code:76140-2512
Practice Address - Country:US
Practice Address - Phone:682-551-0568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable