Provider Demographics
NPI:1083309777
Name:FAITH GLOBAL HEALTHCARE LLC
Entity Type:Organization
Organization Name:FAITH GLOBAL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GERMAINE
Authorized Official - Middle Name:SABINE
Authorized Official - Last Name:DE MBANGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-643-6544
Mailing Address - Street 1:14638 ENDSLEY TURN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-2744
Mailing Address - Country:US
Mailing Address - Phone:240-643-6544
Mailing Address - Fax:
Practice Address - Street 1:14638 ENDSLEY TURN
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-2744
Practice Address - Country:US
Practice Address - Phone:240-643-6544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities