Provider Demographics
NPI:1033999156
Name:FAITH PALLIATIVE CARE
Entity Type:Organization
Organization Name:FAITH PALLIATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-840-7776
Mailing Address - Street 1:123 JOHNSTOWN DR
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65742-9366
Mailing Address - Country:US
Mailing Address - Phone:417-753-7707
Mailing Address - Fax:417-501-4392
Practice Address - Street 1:123 JOHNSTOWN DR
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65742-9366
Practice Address - Country:US
Practice Address - Phone:417-753-7707
Practice Address - Fax:417-501-4392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty