Provider Demographics
NPI:1144226499
Name:FAITH COMMUNITY HOSPICE LLC
Entity Type:Organization
Organization Name:FAITH COMMUNITY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:BSN,RN
Authorized Official - Phone:281-422-0414
Mailing Address - Street 1:4721 GARTH RD
Mailing Address - Street 2:STE H
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2153
Mailing Address - Country:US
Mailing Address - Phone:281-422-0414
Mailing Address - Fax:281-422-9605
Practice Address - Street 1:4721 GARTH RD
Practice Address - Street 2:STE H
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2153
Practice Address - Country:US
Practice Address - Phone:281-422-0414
Practice Address - Fax:281-422-9605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009465251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001013321Medicaid