Provider Demographics
NPI:1760152441
Name:VICTORY SEVENTH-DAY ADVENTIST CHURCH
Entity Type:Organization
Organization Name:VICTORY SEVENTH-DAY ADVENTIST CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH MINISTRIES DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR-BOGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-925-2044
Mailing Address - Street 1:1271 BURKE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5037
Mailing Address - Country:US
Mailing Address - Phone:646-925-2044
Mailing Address - Fax:
Practice Address - Street 1:1271 BURKE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5037
Practice Address - Country:US
Practice Address - Phone:646-925-2044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty