Bloomington Pentecostal Church of God
NPI #1285598243 in Lytle Creek, California
Provider Information
- NPI Number
- 1285598243
- Entity Type
- Organization
- Organization Name
- Bloomington Pentecostal Church of God
- Primary Specialty
- Case Manager/Care Coordinator
- Enumeration Date
- Dec 15, 2025
- Last Updated
- Dec 15, 2025
Practice Location
- Address
- 585 LYTLE CREEK RD
- City
- Lytle Creek
- State
- California
- ZIP Code
- 92358-9758
- Phone
- (909) 900-6011
Authorized Official
- Name
- JOHN DEATHERAGE, ORDAINED
- Title
- PASTOR
- Phone
- (909) 900-6011
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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