NPI 1407001332

Wards Holy Management Outreach Church

Organisation Point of Service Detroit, MI

Practice location

Address: 12410 Wyoming St Fl 2, Detroit, MI 48204
Phone: (313) 834-4339
Fax: (313) 933-4339
Mailing address: 25687 Forestview Dr, Southfield, MI 48033-2944

Authorised official

Name: Idella Darlene Ward
Title: Ceo
Phone: (313) 655-2975

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 6501333434 (MI)

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Registry record

NPI: 1407001332
Entity type: Organization
NPI issued: 19 Nov 2008
Record last updated: 26 Nov 2008

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.