Provider Demographics
NPI:1760839435
Name:SOLOMON TEMPLE MINISTRIES
Entity Type:Organization
Organization Name:SOLOMON TEMPLE MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GASAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTORATE & MA
Authorized Official - Phone:337-794-2071
Mailing Address - Street 1:1917 HARLESS ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-1036
Mailing Address - Country:US
Mailing Address - Phone:337-794-2071
Mailing Address - Fax:337-478-1379
Practice Address - Street 1:1917 HARLESS ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-1036
Practice Address - Country:US
Practice Address - Phone:337-794-2071
Practice Address - Fax:337-478-1379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care