Organization
INTERDENOMINATIONAL CHURCH OF CHRISTIAN LOVE, INC
Active
Other names
St Martin's Family Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER PUMPHREY (FOUNDER)
(414) 961-1614
Entity
Organization
Contact information
Practice address
6310 N PORT WASHINGTON RD, GLENDALE, WI 53217-4300
(414) 961-1614
(414) 961-1616
Mailing address
6310 N PORT WASHINGTON RD, GLENDALE, WI 53217-4300
(414) 961-1614
(414) 961-1616
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
09/21/2012
Last updated
10/31/2012
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