Provider Demographics
NPI:1225318058
Name:FAITHWORKS, INC
Entity Type:Organization
Organization Name:FAITHWORKS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:MAXINE
Authorized Official - Last Name:FODAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:513-371-1195
Mailing Address - Street 1:11424 OXFORDSHIRE LN
Mailing Address - Street 2:LEVEL B
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-2813
Mailing Address - Country:US
Mailing Address - Phone:513-371-1195
Mailing Address - Fax:513-648-9926
Practice Address - Street 1:11424 OXFORDSHIRE LN
Practice Address - Street 2:LEVEL B
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-2813
Practice Address - Country:US
Practice Address - Phone:513-371-1195
Practice Address - Fax:513-648-9926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3110001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3110001OtherODMRDD
OH2802711Medicaid