Provider Demographics
NPI:1770865651
Name:ANGLICAN MISSION INTERNATIONAL INC
Entity Type:Organization
Organization Name:ANGLICAN MISSION INTERNATIONAL INC
Other - Org Name:ANGLICAN MISION SOCIETY OF RICHMOND INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:VARGHESE
Authorized Official - Last Name:AMBALAVELIL
Authorized Official - Suffix:
Authorized Official - Credentials:MSED(CRMD),PHD,P/C
Authorized Official - Phone:972-816-3532
Mailing Address - Street 1:3508 ACROPOLIS WAY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-8994
Mailing Address - Country:US
Mailing Address - Phone:972-816-3532
Mailing Address - Fax:972-422-2370
Practice Address - Street 1:3508 ACROPOLIS WAY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-8994
Practice Address - Country:US
Practice Address - Phone:972-816-3532
Practice Address - Fax:972-422-2370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health