Organization
LOVE OVERWHELMING
Active
Other names
Kelso Foursquare Church
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES D HENDRICKSON (EXECUTIVE DIRECTOR)
(360) 749-8056
Entity
Organization
Contact information
Practice address
304 COWLITZ WAY, KELSO, WA 98626-4110
(360) 749-8056
Mailing address
PO BOX 42, KELSO, WA 98626-0003
(360) 749-8056
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/06/2015
Last updated
04/06/2015
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