Provider Demographics
NPI:1265866719
Name:FAITHWORKS
Entity Type:Organization
Organization Name:FAITHWORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KERENSA
Authorized Official - Middle Name:VERONICA
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LCPA
Authorized Official - Phone:972-293-2500
Mailing Address - Street 1:1801 N HAMPTON RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2391
Mailing Address - Country:US
Mailing Address - Phone:972-293-2500
Mailing Address - Fax:214-210-0219
Practice Address - Street 1:1801 N HAMPTON RD
Practice Address - Street 2:SUITE 400
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2391
Practice Address - Country:US
Practice Address - Phone:972-293-2500
Practice Address - Fax:214-210-0219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-02
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX867939-4210253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency