Godly Ambition of New Generation

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

1042065 Issued in SC

Legal business name

GODLY AMBITION OF NEW GENERATION

Practice address

3501 E Winlark Dr
Florence, SC 29506-8637

Phone

(843) 621-2696

NPI assigned

Jun 3, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Deann G Lesane, MA, AS

Title

Program Director

Phone

(843) 621-2696

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1366855876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 E WINLARK DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295068637",
            "telephone_number": "843-621-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 E WINLARK DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295068637",
            "telephone_number": "843-621-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GODLY AMBITION OF NEW GENERATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "LESANE",
        "authorized_official_first_name": "DEANN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "843-621-2696",
        "authorized_official_credential": "MA, AS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "SC",
            "license": "1042065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Florence, SC
• Providers in Florence, SC by specialty
• Preferred Provider Organization in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.