Provider Demographics
NPI:1780709105
Name:ADVENT GROUP MINISTRIES
Entity type:Organization
Organization Name:ADVENT GROUP MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-281-0708
Mailing Address - Street 1:90 GREAT OAKS BLVD
Mailing Address - Street 2:108
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1314
Mailing Address - Country:US
Mailing Address - Phone:408-847-0504
Mailing Address - Fax:
Practice Address - Street 1:7455 FURLONG AVE
Practice Address - Street 2:GENESIS HOME
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-8022
Practice Address - Country:US
Practice Address - Phone:408-847-0504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health