Provider Demographics
NPI:1407286115
Name:HOUSE OF ZION CHURCH INC.
Entity Type:Organization
Organization Name:HOUSE OF ZION CHURCH INC.
Other - Org Name:H.O.O.D. INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:302-521-5989
Mailing Address - Street 1:731 VANDEVER AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-5023
Mailing Address - Country:US
Mailing Address - Phone:302-377-0757
Mailing Address - Fax:
Practice Address - Street 1:731 VANDEVER AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-5023
Practice Address - Country:US
Practice Address - Phone:302-377-0757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health