Provider Demographics
NPI:1629410402
Name:BORN AGAIN MINISTRIES
Entity Type:Organization
Organization Name:BORN AGAIN MINISTRIES
Other - Org Name:I-KARE SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRISCO
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:804-439-1212
Mailing Address - Street 1:PO BOX 7101
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23509-0101
Mailing Address - Country:US
Mailing Address - Phone:804-439-1212
Mailing Address - Fax:757-333-6380
Practice Address - Street 1:2545 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-4521
Practice Address - Country:US
Practice Address - Phone:804-439-1212
Practice Address - Fax:755-333-6380
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BORN AGAIN MINISTRIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-22
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization