Provider Demographics
NPI:1508372012
Name:HARVEST IN TIME CHRISTIAN UNIVERSITY & SEMINARY
Entity Type:Organization
Organization Name:HARVEST IN TIME CHRISTIAN UNIVERSITY & SEMINARY
Other - Org Name:HARVEST FAITH BASED THERAPEUTIC COUNSELING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ARCH BISHOP
Authorized Official - Prefix:DR
Authorized Official - First Name:ZENO
Authorized Official - Middle Name:B
Authorized Official - Last Name:DARDEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:219-902-4739
Mailing Address - Street 1:5330 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-1555
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5330 BROADWAY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-1555
Practice Address - Country:US
Practice Address - Phone:219-980-6107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty