Provider Demographics
NPI:1255735577
Name:PIVOT MINISTRIES, INC.
Entity type:Organization
Organization Name:PIVOT MINISTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:KINIRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-336-9263
Mailing Address - Street 1:485 JANE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06608-1707
Mailing Address - Country:US
Mailing Address - Phone:203-336-9263
Mailing Address - Fax:203-610-6765
Practice Address - Street 1:485 JANE ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06608-1707
Practice Address - Country:US
Practice Address - Phone:203-336-9263
Practice Address - Fax:203-610-6765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility