Provider Demographics
NPI:1710479076
Name:CHRISTIAN LIFE GUIDANCE
Entity Type:Organization
Organization Name:CHRISTIAN LIFE GUIDANCE
Other - Org Name:ZIMZUM CONSULTING COLLABORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-PARTNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:AGENTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-730-1757
Mailing Address - Street 1:1325 GRANGER RD
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18067-9132
Mailing Address - Country:US
Mailing Address - Phone:610-730-1757
Mailing Address - Fax:
Practice Address - Street 1:520 E BROAD ST STE 2
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6330
Practice Address - Country:US
Practice Address - Phone:610-973-5335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-02
Last Update Date:2018-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-07-3786103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty