Make That Change Ministry Outreach Church

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

MAKE THAT CHANGE MINISTRY OUTREACH CHURCH

Practice address

11170 Hawthorne
Southgate, MI 48195-8540

Phone

(313) 549-6059

Fax

(313) 305-4316

NPI assigned

Mar 24, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Tony Smith

Title

Ceo

Phone

(313) 549-6059

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1528200458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3044 CORTLAND ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482063400",
            "telephone_number": "313-549-6059",
            "fax_number": "313-305-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11170 HAWTHORNE",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481958540",
            "telephone_number": "313-549-6059",
            "fax_number": "313-305-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKE THAT CHANGE MINISTRY OUTREACH CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-549-6059",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Marie Maiden
• Abbie Lynn Maikoski
• Kelly Mainville
• Amber R Majtyka
• Alina Maria Mak, OD
• Taraneh Makhmali, LLMSW
• Daleeda Hassan Makki
• Elena Maria Makssoud
• Jenna Malallah
• Paul Malick, D.O.

• Voluntary or Charitable Agency in Southgate, MI
• Providers in Southgate, MI by specialty
• Voluntary or Charitable Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.