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Organization

JKLR MINISTRIES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GERALD LEROY RANDOLPH REV (DIRECTOR)
(719) 569-2248
Entity
Organization

Contact information

Practice address
3930 RIDGE DR, # E, PUEBLO, CO 81008-1766
(719) 569-2248
(719) 595-0085
Mailing address
140 W 29TH ST, 3352, PUEBLO, CO 81008-1002
(719) 569-2248
(719) 595-0085

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
CO

Other

Enumeration date
03/30/2009
Last updated
03/30/2009
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