| Green Acres Baptist Church | |
|
5755 Eagles Nest Blvd Ste 4 Tyler TX 75703-6236 | |
| (903) 533-1817 | |
| Not Available |
| Full Name | Green Acres Baptist Church |
|---|---|
| Speciality | Counselor |
| Location | 5755 Eagles Nest Blvd Ste 4, Tyler, Texas |
| Authorized Official Name and Position | Jaime Dawn Cornelius (CLINIC DIRECTOR) |
| Authorized Official Contact | 9035331817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Acres Baptist Church 1607 Troup Hwy Tyler TX 75701-5799 Ph: (903) 533-1817 | Green Acres Baptist Church 5755 Eagles Nest Blvd Ste 4 Tyler TX 75703-6236 Ph: (903) 533-1817 |
| NPI Number | 1376228619 |
|---|---|
| Provider Enumeration Date | 06/15/2023 |
| Last Update Date | 06/15/2023 |
| Certification Date | 06/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376228619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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