Provider Demographics
NPI:1922334374
Name:KNOUNA OUTREACH MINISTRY CHURCH
Entity Type:Organization
Organization Name:KNOUNA OUTREACH MINISTRY CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAYSARAH
Authorized Official - Middle Name:G
Authorized Official - Last Name:KNOUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-979-2224
Mailing Address - Street 1:8229 LAKE PINE DR
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-4528
Mailing Address - Country:US
Mailing Address - Phone:248-979-2224
Mailing Address - Fax:313-273-4832
Practice Address - Street 1:8229 LAKE PINE DR
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-4528
Practice Address - Country:US
Practice Address - Phone:248-979-2224
Practice Address - Fax:313-273-4832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable