# CHILDREN OF PROMISE MENTORING PROGRAM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568058410
- **Authorized official:** MRS. GIORANNIA MARTINE PLEDGEJOHNSON (VICE PRESIDENT/TREASURER)
- **Authorized official phone:** (319) 505-7537

## Contact information

- **Practice address:** 1030 5TH AVE SUITE \# 1200, CEDAR RAPIDS, IA 52403
- **Practice address phone:** (319) 529-1543
- **Practice address fax:** (833) 667-0184
- **Mailing address:** 1143 LONGFELLOW AVE, WATERLOO, IA 50703
- **Mailing address phone:** (319) 529-1543
- **Mailing address fax:** (833) 667-0184

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 12/15/2020
- **Last updated:** 12/15/2020