Provider Demographics
NPI:1467627034
Name:REDEEMER LUTHERAN CHURCH
Entity Type:Organization
Organization Name:REDEEMER LUTHERAN CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COUNSELING, SR. PASTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:S
Authorized Official - Last Name:DRAEGER
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:650-366-7882
Mailing Address - Street 1:468 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2062
Mailing Address - Country:US
Mailing Address - Phone:650-366-7882
Mailing Address - Fax:650-366-5898
Practice Address - Street 1:468 GRAND ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-2062
Practice Address - Country:US
Practice Address - Phone:650-366-7882
Practice Address - Fax:650-366-5898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34206251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health