Provider Demographics
NPI:1225433253
Name:FAITH WORKS ADULT DAY SUPPORT CENTER
Entity Type:Organization
Organization Name:FAITH WORKS ADULT DAY SUPPORT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:804-363-8373
Mailing Address - Street 1:1588 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3915
Mailing Address - Country:US
Mailing Address - Phone:804-918-5928
Mailing Address - Fax:804-918-5931
Practice Address - Street 1:1588 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3915
Practice Address - Country:US
Practice Address - Phone:804-918-5928
Practice Address - Fax:804-918-5931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care