House of Prayer Christian Academy

NPI #1700155595 in East Saint Louis, Illinois

Provider Information

NPI Number: 1700155595
Entity Type: Organization
Organization Name: House of Prayer Christian Academy
Primary Specialty: Counselor
Enumeration Date: Dec 22, 2011
Last Updated: Dec 22, 2011

Practice Location

Address: 5501 N PARK DR
City: East Saint Louis
State: Illinois
ZIP Code: 62204-2121
Phone: (618) 274-3850

Authorized Official

Name: MR. ANTHONY DEWAYNE PETTIFORD
Title: CEO
Phone: (618) 274-3850

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Pastoral — Pastoral	101YP1600X
Counselor - Professional — Professional	101YP2500X
Marriage & Family Therapist	106H00000X
Counselor	101Y00000X	Primary

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