Provider Demographics
NPI:1407082977
Name:NEW FOUNDATION 180 OUTREACH MINISTRY
Entity Type:Organization
Organization Name:NEW FOUNDATION 180 OUTREACH MINISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-752-1279
Mailing Address - Street 1:22319 LA SEINE ST APT 301
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4044
Mailing Address - Country:US
Mailing Address - Phone:248-752-1279
Mailing Address - Fax:245-855-9624
Practice Address - Street 1:22319 LA SEINE ST APT 301
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4044
Practice Address - Country:US
Practice Address - Phone:248-752-1279
Practice Address - Fax:245-855-9624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable