Provider Demographics
NPI:1871155309
Name:GODS LOVE OUTREACH MINISTRIES
Entity type:Organization
Organization Name:GODS LOVE OUTREACH MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-443-3680
Mailing Address - Street 1:2150 PORTOLA AVE STE D109
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-1784
Mailing Address - Country:US
Mailing Address - Phone:925-570-3282
Mailing Address - Fax:925-443-3696
Practice Address - Street 1:1117 S GRANT ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-1626
Practice Address - Country:US
Practice Address - Phone:925-570-3282
Practice Address - Fax:925-443-3696
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GODS LOVE OUTREACH MINISTRIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-04
Last Update Date:2019-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness