Provider Demographics
NPI:1275958621
Name:FAITH MISSION INC.
Entity Type:Organization
Organization Name:FAITH MISSION INC.
Other - Org Name:LUTHERAN SOCIAL SERVICES/FAITH MISSION
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLILO
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:614-224-6617
Mailing Address - Street 1:245 N GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-2641
Mailing Address - Country:US
Mailing Address - Phone:614-224-6617
Mailing Address - Fax:614-221-0936
Practice Address - Street 1:245 N GRANT AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2641
Practice Address - Country:US
Practice Address - Phone:614-224-6617
Practice Address - Fax:614-221-0936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health