Provider Demographics
NPI:1306388483
Name:FAITHFUL SERVANTS CARE, LLC
Entity Type:Organization
Organization Name:FAITHFUL SERVANTS CARE, LLC
Other - Org Name:FAITHFUL SERVANTS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:SKELTON
Authorized Official - Last Name:AINSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-302-4477
Mailing Address - Street 1:304 GRIGGS ACRES DR
Mailing Address - Street 2:
Mailing Address - City:POINT HARBOR
Mailing Address - State:NC
Mailing Address - Zip Code:27964-9722
Mailing Address - Country:US
Mailing Address - Phone:804-302-4477
Mailing Address - Fax:804-302-4474
Practice Address - Street 1:3113 LITTLEBURY DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-7108
Practice Address - Country:US
Practice Address - Phone:804-302-4477
Practice Address - Fax:804-302-4474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-171371253Z00000X
385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC7151OtherHCO LICENSE # W/ NC DHHS
VAHCO-171371OtherHOME CARE ORGANIZATION LICENSE # WITH VA DEPT OF HEALTH
VA0185487987Medicaid