Provider Demographics
NPI:1760264246
Name:DIVINE TRUTH UNITY FELLOWSHIP CHURCH, INC
Entity Type:Organization
Organization Name:DIVINE TRUTH UNITY FELLOWSHIP CHURCH, INC
Other - Org Name:DIVINE TRUTH UNITY FELLOWSHIP CHURCH DBA RAINBOW PRIDE YOUTH ALLIANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BENITA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:909-519-3927
Mailing Address - Street 1:3540 S NORTH SHORE DR
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-9130
Mailing Address - Country:US
Mailing Address - Phone:909-519-3927
Mailing Address - Fax:
Practice Address - Street 1:330 N D ST # 429
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1545
Practice Address - Country:US
Practice Address - Phone:909-519-3927
Practice Address - Fax:909-363-7974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-18
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251V00000XAgenciesVoluntary or Charitable
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health