Provider Demographics
NPI:1831800044
Name:GOD'S PROPHETIC SERVANTS, LLC
Entity type:Organization
Organization Name:GOD'S PROPHETIC SERVANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMMUNICATIONS/ COMPLIA
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KYLER
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:253-431-3598
Mailing Address - Street 1:2424 S 41ST ST APT B547
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-7434
Mailing Address - Country:US
Mailing Address - Phone:253-970-6499
Mailing Address - Fax:
Practice Address - Street 1:2424 S 41ST ST APT B547
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7434
Practice Address - Country:US
Practice Address - Phone:253-970-6499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty