Provider Demographics
NPI:1689344327
Name:GODS PROPHETIC SERVANTS GPS
Entity Type:Organization
Organization Name:GODS PROPHETIC SERVANTS GPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR;
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:KYLER
Authorized Official - Suffix:
Authorized Official - Credentials:BEHAVIORAL INTERVEN
Authorized Official - Phone:253-431-3598
Mailing Address - Street 1:8016 MADEIRA DR
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-7919
Mailing Address - Country:US
Mailing Address - Phone:253-431-3598
Mailing Address - Fax:
Practice Address - Street 1:8016 MADEIRA DR
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-7919
Practice Address - Country:US
Practice Address - Phone:253-431-3598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-15
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty