Provider Demographics
NPI:1508099821
Name:WORD OF TRUTH CHRISTIAN CHURCH U.S.A., INC.
Entity Type:Organization
Organization Name:WORD OF TRUTH CHRISTIAN CHURCH U.S.A., INC.
Other - Org Name:TRUTH COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1219-576-4623
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46402-0032
Mailing Address - Country:US
Mailing Address - Phone:219-614-0793
Mailing Address - Fax:
Practice Address - Street 1:141 W 46TH AVE
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46408-3905
Practice Address - Country:US
Practice Address - Phone:219-614-0793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health