Provider Demographics
NPI:1063008969
Name:MB FAITHFUL HOME CARE LLC
Entity Type:Organization
Organization Name:MB FAITHFUL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MABLE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMEGASHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-819-6441
Mailing Address - Street 1:1300 WISCONSIN AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-2555
Mailing Address - Country:US
Mailing Address - Phone:412-819-6441
Mailing Address - Fax:
Practice Address - Street 1:1300 WISCONSIN AVE APT 4
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216-2555
Practice Address - Country:US
Practice Address - Phone:412-819-6441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care