NPI 1003652660
Full Gospel
Practice location
- Address
- 857 Prospect St, Valparaiso, IN 46385-4552
- Phone
- (219) 281-9481
- Mailing address
- 2701 Willowcreek Rd Unit 1841, Portage, IN 46368-7476
Authorised official
- Name
- Antoinette Cundiff
- Title
- President/Pastor
- Phone
- (219) 281-9481
Registered specialties
In Home Supportive Care Agency
Primary
Registry record
- NPI
- 1003652660
- Entity type
- Organization
- NPI issued
- 3 Jul 2024
- Record last updated
- 3 Jul 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.