Provider Demographics
NPI:1649888157
Name:ONE TOUCH OF CHRIST EVANGELISTIC MINISTRIES
Entity type:Organization
Organization Name:ONE TOUCH OF CHRIST EVANGELISTIC MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-328-4819
Mailing Address - Street 1:3160 E MT RAINIER DR
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-7272
Mailing Address - Country:US
Mailing Address - Phone:612-328-4819
Mailing Address - Fax:763-762-6537
Practice Address - Street 1:350 VINTON AVE STE 102
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3000
Practice Address - Country:US
Practice Address - Phone:612-328-4819
Practice Address - Fax:763-762-6537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1992366645Medicaid