Provider Demographics
NPI:1902160542
Name:GOD AND I LOVES YOU FOUNDATION
Entity Type:Organization
Organization Name:GOD AND I LOVES YOU FOUNDATION
Other - Org Name:VIRTUOUS WOMAN OF COLOR PURPLE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR AND CHAIRMAN
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNITRA
Authorized Official - Middle Name:TINIKA
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-456-0535
Mailing Address - Street 1:30 N SAGINAW ST
Mailing Address - Street 2:SUITE 802
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-2161
Mailing Address - Country:US
Mailing Address - Phone:888-629-4161
Mailing Address - Fax:248-456-0535
Practice Address - Street 1:30 N SAGINAW ST
Practice Address - Street 2:SUITE 802
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2161
Practice Address - Country:US
Practice Address - Phone:888-629-4161
Practice Address - Fax:248-456-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI70376N305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization