Organization
MAKE THAT CHANGE MINISTRY OUTREACH CHURCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY SMITH (CEO)
(313) 549-6059
Entity
Organization
Contact information
Practice address
11170 HAWTHORNE, SOUTHGATE, MI 48195-8540
(313) 549-6059
(313) 305-4316
Mailing address
3044 CORTLAND ST, DETROIT, MI 48206-3400
(313) 549-6059
(313) 305-4316
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
03/24/2009
Last updated
03/24/2009
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