INTERDENOMINATIONAL CHURCH OF CHRISTIAN LOVE, INC (NPI# 1770834467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770834467 |
| Entity Type | Organization |
| Organization Name | INTERDENOMINATIONAL CHURCH OF CHRISTIAN LOVE, INC |
| Other Organization Name | ST MARTIN'S FAMILY SERVICES |
| Practice Address |
6310 N Port Washington Rd Glendale WI 53217-4300 |
| Practice Telephone | 4149611614 |
| Practice Fax Number | 4149611616 |
| Mailing Telephone | 4149611614 |
| Mailing Fax Number | 4149611616 |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2012-10-31 |
| Authorized Official Name | DR. ROGER PUMPHREY (FOUNDER) |
| Authorized Official Telephone | 4149611614 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| Other Name | Type Code |
|---|---|
| St Martin's Family Services | Doing Business As Name - Organization |
| Street Address |
6310 N PORT WASHINGTON RD |
| City | GLENDALE |
| State | WI |
| Zip Code | 53217-4300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063464436 | Fannie M. Leflore | Counselor | 6310 N Port Washington Rd, Office Space Inside R.e.a.c.h. Clinic, Glendale, WI 53217-4300 | 2006-05-16 |
| 1023337706 | Frances B Pitt | Counselor | 6310 N Port Washington Rd, Glendale, WI 53217-4300 | 2010-05-20 |
| 1386975100 | Gretchen J. Gill | Counselor | 6310 N Port Washington Rd, Glendale, WI 53217-4300 | 2010-01-18 |
| 1578891107 | Candice Lynn Lipski | Counselor | 6310 N Port Washington Rd, Glendale, WI 53217-4300 | 2009-11-19 |
| 1144555152 | R.e.a.c.h. Inc. Comprehensive Mental Health Clinic | Community/Behavioral Health | 6310 N Port Washington Rd, Glendale, WI 53217-4300 | 2009-10-08 |
| 1740373430 | Kurth Chiropractic, Sc | Chiropractor | 6310 N Port Washington Rd, Glendale, WI 53217-4300 | 2006-10-02 |
| 1154414829 | Brian Kurth | Chiropractor | 6310 N Port Washington Rd, Glendale, WI 53217-4300 | 2006-10-02 |
| 1225139884 | Khyana K Pumphrey | Counselor | 6310 N Port Washington Rd, Glendale, WI 53217-4300 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632587 | Jasmine Dockery | Pharmacist | 5400 N Port Washington, Glendale, WI 53217 | 2020-02-23 |
| 1174017339 | North Lakes Nursing Home Health Care Agency LLC | Home Health | 225 E Fairmount Ave, Milwaukee, WI 53217 | 2018-06-20 |
| 1083140289 | Miriah Ann King, Ms, Lpc | Counselor | 7805 North Boyd Way, Fox Point, WI 53217 | 2017-05-08 |
| 1245783067 | Lakesha L Jones | Counselor | 5235 N Ironwood Rd, Glendale, WI 53217 | 2016-07-28 |
| 1750783312 | Ibrahim S Abouzeid | Specialist/Technologist, Other | 333 W Brown Deer Road, #240, Milwaukee, WI 53217 | 2014-09-25 |
| 1255733598 | Victoria Gorodetsky | Pharmacist | 229 W Indian Creek Ct, Milwaukee, WI 53217 | 2014-09-18 |
| 1174800049 | John Herman Esser | Internal Medicine | 1050 W Acacia Rd, Milwaukee, WI 53217 | 2011-11-07 |
| 1710298351 | Leann M Harman | Physical Therapist | 5333 N Port Washington Rd Ste B, Glendale, WI 53217 | 2010-06-29 |
| 1306012455 | Emily Marie Gallagher | Speech-Language Pathologist | 6700 N. Port Washington Road, Milwaukee, WI 53217 | 2008-05-07 |
| 1164625455 | Mary Catherine Enderlin | Psychologist | 6110 N Port Washington Road, The Cambridge Group, Glendale, WI 53217 | 2007-06-06 |
| Find all providers in zip 53217 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
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| Find all providers in GLENDALE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.