Provider Demographics
NPI:1467722074
Name:PROVIDENCE SELF SUFFICIENCY MINISTRIES, INC.
Entity Type:Organization
Organization Name:PROVIDENCE SELF SUFFICIENCY MINISTRIES, INC.
Other - Org Name:GUERIN WOODS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SISTER
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:ZELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-951-1878
Mailing Address - Street 1:8037 UNRUH DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47122-8759
Mailing Address - Country:US
Mailing Address - Phone:812-951-1878
Mailing Address - Fax:812-951-1659
Practice Address - Street 1:1400 CRISTIANI WAY
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:IN
Practice Address - Zip Code:47122-8783
Practice Address - Country:US
Practice Address - Phone:812-951-1878
Practice Address - Fax:812-951-1659
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROVIDENCE SELF SUFFICIENCY MINISTRIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health