Provider Demographics
NPI:1063660843
Name:MORNING BY MORNING MINISTRIES INTERNATIONAL, LLC
Entity type:Organization
Organization Name:MORNING BY MORNING MINISTRIES INTERNATIONAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLI
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:585-233-4100
Mailing Address - Street 1:63417 LEDGESTONE CT
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7723
Mailing Address - Country:US
Mailing Address - Phone:585-233-4100
Mailing Address - Fax:
Practice Address - Street 1:1707 SW PARKWAY DR
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2581
Practice Address - Country:US
Practice Address - Phone:585-233-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL4279251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health