Provider Demographics
NPI:1669601316
Name:DESERT PALMS OUTREACH MINISTRIES
Entity type:Organization
Organization Name:DESERT PALMS OUTREACH MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:YOUSIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-379-0210
Mailing Address - Street 1:5530 ACORN LN
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-3163
Mailing Address - Country:US
Mailing Address - Phone:248-379-0210
Mailing Address - Fax:
Practice Address - Street 1:5530 ACORN LN
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-3163
Practice Address - Country:US
Practice Address - Phone:248-379-0210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable