Provider Demographics
NPI:1811642093
Name:GOD CHANGES LIVES MINISTRIES, INC.
Entity type:Organization
Organization Name:GOD CHANGES LIVES MINISTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARNUCCIO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA
Authorized Official - Phone:609-654-7447
Mailing Address - Street 1:127 KIHADE TRL
Mailing Address - Street 2:
Mailing Address - City:MEDFORD LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-1703
Mailing Address - Country:US
Mailing Address - Phone:609-654-7447
Mailing Address - Fax:
Practice Address - Street 1:111 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-9602
Practice Address - Country:US
Practice Address - Phone:609-654-7447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution