Provider Demographics
NPI:1801119037
Name:GAINESVILLE COMMUNITY MINISTRY
Entity type:Organization
Organization Name:GAINESVILLE COMMUNITY MINISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-372-8162
Mailing Address - Street 1:238 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-6552
Mailing Address - Country:US
Mailing Address - Phone:352-372-8162
Mailing Address - Fax:352-372-8131
Practice Address - Street 1:238 SW 4TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-6552
Practice Address - Country:US
Practice Address - Phone:352-372-8162
Practice Address - Fax:352-372-8131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable