Provider Demographics
NPI:1780810671
Name:BLESSED INSTITUTE MINISTRY CHURCH
Entity type:Organization
Organization Name:BLESSED INSTITUTE MINISTRY CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-886-1916
Mailing Address - Street 1:7881 HAMLET CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-1268
Mailing Address - Country:US
Mailing Address - Phone:313-886-1916
Mailing Address - Fax:
Practice Address - Street 1:7881 HAMLET CT
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1268
Practice Address - Country:US
Practice Address - Phone:313-886-1916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable