Provider Demographics
NPI:1407537970
Name:TAKEN BY FAITH LLC
Entity Type:Organization
Organization Name:TAKEN BY FAITH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:636-244-2242
Mailing Address - Street 1:3930 S OLD HIGHWAY 94 STE 105
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-2836
Mailing Address - Country:US
Mailing Address - Phone:636-244-2242
Mailing Address - Fax:
Practice Address - Street 1:3930 S OLD HIGHWAY 94 STE 105
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-2836
Practice Address - Country:US
Practice Address - Phone:636-244-2242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care