Provider Demographics
NPI:1558486233
Name:ADVENT GROUP MINISTRIES
Entity Type:Organization
Organization Name:ADVENT GROUP MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-281-0708
Mailing Address - Street 1:90 GREAT OAKS BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1314
Mailing Address - Country:US
Mailing Address - Phone:408-281-0708
Mailing Address - Fax:
Practice Address - Street 1:865 BLACK WALNUT CT
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-3722
Practice Address - Country:US
Practice Address - Phone:408-779-5841
Practice Address - Fax:408-281-2658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health