Provider Demographics
NPI:1609057447
Name:OPPORTUNITY BAPTIST CHURCH, INC.
Entity Type:Organization
Organization Name:OPPORTUNITY BAPTIST CHURCH, INC.
Other - Org Name:OPPORTUNITY BAPTIST COMMUNITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:SR
Authorized Official - Credentials:BA
Authorized Official - Phone:323-481-9800
Mailing Address - Street 1:10513 S VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90044-3021
Mailing Address - Country:US
Mailing Address - Phone:323-481-9800
Mailing Address - Fax:
Practice Address - Street 1:10513 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-3021
Practice Address - Country:US
Practice Address - Phone:323-481-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPPORTUNITY BAPTIST CHURCH INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management