Provider Demographics
NPI:1063739761
Name:SUCCESSFUL BLESSINGS OUTREACH CHURCH
Entity type:Organization
Organization Name:SUCCESSFUL BLESSINGS OUTREACH CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-590-5994
Mailing Address - Street 1:8903 PLAINVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-2962
Mailing Address - Country:US
Mailing Address - Phone:313-590-5994
Mailing Address - Fax:313-836-1630
Practice Address - Street 1:8903 PLAINVIEW AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-2962
Practice Address - Country:US
Practice Address - Phone:313-590-5994
Practice Address - Fax:313-836-1630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable