Provider Demographics
NPI:1891023834
Name:EL SHADDAI MINISTRY CO.
Entity Type:Organization
Organization Name:EL SHADDAI MINISTRY CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MSN, DNSC
Authorized Official - Phone:574-273-1733
Mailing Address - Street 1:53280 PLACID DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46637-3542
Mailing Address - Country:US
Mailing Address - Phone:574-273-1733
Mailing Address - Fax:
Practice Address - Street 1:53280 PLACID DR
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46637-3542
Practice Address - Country:US
Practice Address - Phone:574-273-1733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health