Provider Demographics
NPI:1528401643
Name:WORD OF DELIVERANCE DIVINE CARE INC
Entity Type:Organization
Organization Name:WORD OF DELIVERANCE DIVINE CARE INC
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWTON
Authorized Official - Suffix:
Authorized Official - Credentials:SOCIAL WORKER
Authorized Official - Phone:662-719-7800
Mailing Address - Street 1:216 N CHRISMAN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2730
Mailing Address - Country:US
Mailing Address - Phone:662-843-8797
Mailing Address - Fax:662-843-8772
Practice Address - Street 1:216 N CHRISMAN AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2730
Practice Address - Country:US
Practice Address - Phone:662-843-8797
Practice Address - Fax:662-843-8772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care