Provider Demographics
NPI:1801237292
Name:WADE HARVEST MINISTRIES
Entity type:Organization
Organization Name:WADE HARVEST MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-589-0752
Mailing Address - Street 1:455 ANCHORAGE AVE
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-5304
Mailing Address - Country:US
Mailing Address - Phone:731-589-0752
Mailing Address - Fax:731-287-9472
Practice Address - Street 1:965 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:TN
Practice Address - Zip Code:38001-1577
Practice Address - Country:US
Practice Address - Phone:731-285-1076
Practice Address - Fax:731-287-9472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty