Provider Demographics
NPI:1417016981
Name:FAITH HOME HEALTH, INC
Entity Type:Organization
Organization Name:FAITH HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKPALEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-322-5916
Mailing Address - Street 1:3202 N HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-1614
Mailing Address - Country:US
Mailing Address - Phone:813-876-5500
Mailing Address - Fax:813-876-5519
Practice Address - Street 1:4554 CENTRAL AVE STE D
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-1047
Practice Address - Country:US
Practice Address - Phone:727-322-5916
Practice Address - Fax:727-322-8827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10D0931541251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015529500Medicaid
FL107636Medicare ID - Type UnspecifiedHOME HEALTH CARE SERVICES