Provider Demographics
NPI:1275255028
Name:FAVORED BY GOD HOME CARE ORG LLC
Entity Type:Organization
Organization Name:FAVORED BY GOD HOME CARE ORG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-714-9549
Mailing Address - Street 1:924 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-1473
Mailing Address - Country:US
Mailing Address - Phone:951-658-0700
Mailing Address - Fax:
Practice Address - Street 1:924 N STATE ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-1473
Practice Address - Country:US
Practice Address - Phone:951-658-0700
Practice Address - Fax:951-658-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health