Provider Demographics
NPI:1598995896
Name:LIFE MATTERS MISSIONARY OUTREACH MINISTRIES AND CHURCH
Entity Type:Organization
Organization Name:LIFE MATTERS MISSIONARY OUTREACH MINISTRIES AND CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PASTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JULES
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR OF THEOLOGY
Authorized Official - Phone:804-267-9007
Mailing Address - Street 1:PO BOX 71644
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23255-1644
Mailing Address - Country:US
Mailing Address - Phone:804-267-9007
Mailing Address - Fax:
Practice Address - Street 1:5670 OAK RUN LN
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-1940
Practice Address - Country:US
Practice Address - Phone:804-267-9007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251V00000XAgenciesVoluntary or Charitable
No164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty