Provider Demographics
NPI:1598095168
Name:KNEWLIFE OUTREACH MINISTRIES
Entity Type:Organization
Organization Name:KNEWLIFE OUTREACH MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:IESHA
Authorized Official - Middle Name:SYIDA
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-673-4402
Mailing Address - Street 1:6587 OAKMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-4025
Mailing Address - Country:US
Mailing Address - Phone:313-673-4402
Mailing Address - Fax:
Practice Address - Street 1:6587 OAKMAN BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-4025
Practice Address - Country:US
Practice Address - Phone:313-673-4402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable