Provider Demographics
NPI:1386420511
Name:PROMISE CHILD MINISTRIES
Entity type:Organization
Organization Name:PROMISE CHILD MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-384-6900
Mailing Address - Street 1:3705 BENTLEY PL
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-9006
Mailing Address - Country:US
Mailing Address - Phone:980-384-6900
Mailing Address - Fax:
Practice Address - Street 1:1625 WALKUP AVE STE A
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-3989
Practice Address - Country:US
Practice Address - Phone:980-384-6902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child