Provider Demographics
NPI:1346618972
Name:LIVE BY FAITH PERSONAL CARE SERVICES
Entity Type:Organization
Organization Name:LIVE BY FAITH PERSONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-764-8062
Mailing Address - Street 1:PO BOX 611
Mailing Address - Street 2:
Mailing Address - City:WESTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11977-0611
Mailing Address - Country:US
Mailing Address - Phone:631-764-8062
Mailing Address - Fax:
Practice Address - Street 1:1750 W MAIN ST
Practice Address - Street 2:S14
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-3100
Practice Address - Country:US
Practice Address - Phone:631-764-8062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health