Provider Demographics
NPI:1871288704
Name:CHINO VALLEY BIBLE CHURCH
Entity type:Organization
Organization Name:CHINO VALLEY BIBLE CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, PHD
Authorized Official - Phone:602-663-1491
Mailing Address - Street 1:410 STACEY DR
Mailing Address - Street 2:
Mailing Address - City:CHINO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86323-6497
Mailing Address - Country:US
Mailing Address - Phone:602-663-1491
Mailing Address - Fax:
Practice Address - Street 1:1578 N HWY 89 STE B
Practice Address - Street 2:
Practice Address - City:CHINO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86323-7624
Practice Address - Country:US
Practice Address - Phone:602-663-1491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable