Provider Demographics
NPI:1295323160
Name:CHURCH OF SCIENTOLOGY FLAG SERVICE ORGANIZATION, INC.
Entity type:Organization
Organization Name:CHURCH OF SCIENTOLOGY FLAG SERVICE ORGANIZATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEGAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-445-4338
Mailing Address - Street 1:503 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-4007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:210 S OSCEOLA AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-5121
Practice Address - Country:US
Practice Address - Phone:727-445-4338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory