Provider Demographics
NPI:1417596867
Name:HEAVEN RACE MINISTRIES
Entity Type:Organization
Organization Name:HEAVEN RACE MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SSEBUGWAWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-286-0653
Mailing Address - Street 1:PO BOX 598
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-0598
Mailing Address - Country:US
Mailing Address - Phone:206-229-1836
Mailing Address - Fax:
Practice Address - Street 1:1032 EDMONDS AVE NE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-2920
Practice Address - Country:US
Practice Address - Phone:206-229-1836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management