Provider Demographics
NPI:1689969438
Name:SET THE CAPTIVES FREE DELIVERANCE MINISTRY
Entity Type:Organization
Organization Name:SET THE CAPTIVES FREE DELIVERANCE MINISTRY
Other - Org Name:ST. PAUL CENTER 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:DARNELL
Authorized Official - Last Name:SIMMON-PULLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-908-3856
Mailing Address - Street 1:3824 CRENSHAW BLVD
Mailing Address - Street 2:A
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-1813
Mailing Address - Country:US
Mailing Address - Phone:213-709-6402
Mailing Address - Fax:323-755-3959
Practice Address - Street 1:3824 CRENSHAW BLVD
Practice Address - Street 2:A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-1813
Practice Address - Country:US
Practice Address - Phone:310-908-3856
Practice Address - Fax:323-755-3959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health