Provider Demographics
NPI:1396480638
Name:MISSIONARIES TO MINISTERS, INC.
Entity type:Organization
Organization Name:MISSIONARIES TO MINISTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CO-FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:COUCH
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:408-890-6306
Mailing Address - Street 1:1101 S WINCHESTER BLVD STE H187
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3903
Mailing Address - Country:US
Mailing Address - Phone:408-890-6306
Mailing Address - Fax:408-890-6246
Practice Address - Street 1:1101 S WINCHESTER BLVD STE H187
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3903
Practice Address - Country:US
Practice Address - Phone:408-890-6306
Practice Address - Fax:408-890-6246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty