Provider Demographics
NPI:1518444900
Name:LIFE RESOURCE AND DEVELOPEMENT
Entity Type:Organization
Organization Name:LIFE RESOURCE AND DEVELOPEMENT
Other - Org Name:UPTOWN CHURCH OF CHRIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM MANAGER/ PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:EDD (2018)
Authorized Official - Phone:619-948-3708
Mailing Address - Street 1:3295 MEADE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-4557
Mailing Address - Country:US
Mailing Address - Phone:619-948-3708
Mailing Address - Fax:858-684-1088
Practice Address - Street 1:3295 MEADE AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-4557
Practice Address - Country:US
Practice Address - Phone:619-948-3708
Practice Address - Fax:858-684-1088
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFE RESOURCE AND DEVELOPEMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management