Provider Demographics
NPI:1720304660
Name:MY GOAL OUR MISSION, INC
Entity Type:Organization
Organization Name:MY GOAL OUR MISSION, INC
Other - Org Name:MY GOAL OUR MISSION, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BRISTOW-CHISLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-523-8651
Mailing Address - Street 1:313 US HIGHWAY 70 E STE E
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-4040
Mailing Address - Country:US
Mailing Address - Phone:919-800-0016
Mailing Address - Fax:919-800-0016
Practice Address - Street 1:313 US HIGHWAY 70 E STE E
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-4040
Practice Address - Country:US
Practice Address - Phone:919-800-0016
Practice Address - Fax:919-800-0016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable