Provider Demographics
NPI:1437554714
Name:THE GAQTHERING PLACE LIONHEART MINISTRIES INC
Entity Type:Organization
Organization Name:THE GAQTHERING PLACE LIONHEART MINISTRIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DEYLYNE
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:MCCAMPBELL
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:951-536-1238
Mailing Address - Street 1:9345 DRAGON TREE DR
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92344-4680
Mailing Address - Country:US
Mailing Address - Phone:760-948-9930
Mailing Address - Fax:
Practice Address - Street 1:9345 DRAGON TREE DR
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92344-4680
Practice Address - Country:US
Practice Address - Phone:760-948-9930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty