Provider Demographics
NPI:1558020396
Name:KOLEZ INTERNATIONAL MISSIONS INC
Entity Type:Organization
Organization Name:KOLEZ INTERNATIONAL MISSIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:EZINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-327-0623
Mailing Address - Street 1:7603 GEORGIA AVE NW STE 404
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1617
Mailing Address - Country:US
Mailing Address - Phone:202-327-0623
Mailing Address - Fax:
Practice Address - Street 1:7603 GEORGIA AVE NW STE 404
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1617
Practice Address - Country:US
Practice Address - Phone:202-327-0623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities