Provider Demographics
NPI:1548808413
Name:LUTHERAN ASSOCIATION OF MISSIONARIES AND PILOTS U.S., INC.
Entity type:Organization
Organization Name:LUTHERAN ASSOCIATION OF MISSIONARIES AND PILOTS U.S., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG EAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-783-5267
Mailing Address - Street 1:15400 W CAPITOL DR STE 201
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-2661
Mailing Address - Country:US
Mailing Address - Phone:262-783-5267
Mailing Address - Fax:262-783-5290
Practice Address - Street 1:718 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-8744
Practice Address - Country:US
Practice Address - Phone:480-597-4239
Practice Address - Fax:602-581-3059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty