Provider Demographics
NPI:1942796347
Name:GODS HOUSE OF SOLOMON
Entity Type:Organization
Organization Name:GODS HOUSE OF SOLOMON
Other - Org Name:EASTWARD CHRISTIAN BIBLE COLLEGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EX DIR/PROVOST/COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VERNELL
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:MCAP
Authorized Official - Phone:561-358-2049
Mailing Address - Street 1:PO BOX 2785
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32203-2785
Mailing Address - Country:US
Mailing Address - Phone:561-358-2049
Mailing Address - Fax:
Practice Address - Street 1:1709 HELENA ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-3692
Practice Address - Country:US
Practice Address - Phone:561-358-2049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YA0400X, 282J00000X
251B00000X, 251S00000X, 251V00000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251V00000XAgenciesVoluntary or Charitable
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)