Provider Demographics
NPI:1740759844
Name:THE CHRISTIAN & MISSIONARY ALLIANCE FOUNDATION INC
Entity Type:Organization
Organization Name:THE CHRISTIAN & MISSIONARY ALLIANCE FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-433-7937
Mailing Address - Street 1:15000 SHELL POINT BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-1657
Mailing Address - Country:US
Mailing Address - Phone:239-433-7937
Mailing Address - Fax:239-454-2279
Practice Address - Street 1:15051 SHELL POINT BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-1639
Practice Address - Country:US
Practice Address - Phone:239-433-7937
Practice Address - Fax:239-454-2279
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CHRISTIAN & MISSIONARY ALLIANCE FOUNDATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-19
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care