Provider Demographics
NPI:1275051302
Name:NEW FAMILY CHRISTIAN CHURCH
Entity Type:Organization
Organization Name:NEW FAMILY CHRISTIAN CHURCH
Other - Org Name:NEW LIFE CHRISTIAN COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:WOMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-327-8567
Mailing Address - Street 1:104 N SCHOOL ST STE 308
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-2161
Mailing Address - Country:US
Mailing Address - Phone:209-370-5901
Mailing Address - Fax:
Practice Address - Street 1:104 N SCHOOL ST STE 308
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-2161
Practice Address - Country:US
Practice Address - Phone:209-370-5901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution