Provider Demographics
NPI:1578251252
Name:THE MESSIANIC REFUGE
Entity Type:Organization
Organization Name:THE MESSIANIC REFUGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:CULBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-549-4062
Mailing Address - Street 1:700 BRUSH CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45144-9243
Mailing Address - Country:US
Mailing Address - Phone:937-549-4062
Mailing Address - Fax:
Practice Address - Street 1:990 BRUSH CREEK RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45144-9244
Practice Address - Country:US
Practice Address - Phone:937-549-4062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility