Provider Demographics
NPI:1578837209
Name:WHEAT FIELD MINISTRY, INC
Entity Type:Organization
Organization Name:WHEAT FIELD MINISTRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:GRIPPER
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV
Authorized Official - Phone:704-724-2721
Mailing Address - Street 1:9827 FERNSPRAY RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-7760
Mailing Address - Country:US
Mailing Address - Phone:704-724-2721
Mailing Address - Fax:704-597-7508
Practice Address - Street 1:9700 RESEARCH DR
Practice Address - Street 2:STE 105
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8552
Practice Address - Country:US
Practice Address - Phone:704-412-1912
Practice Address - Fax:704-597-7508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8700589Medicaid