Provider Demographics
NPI:1497461149
Name:CHILDLIKE FAITH FAMILY SERVICES, INC
Entity Type:Organization
Organization Name:CHILDLIKE FAITH FAMILY SERVICES, INC
Other - Org Name:CHILDLIKE FAITH FAMILY SERVICES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-647-2141
Mailing Address - Street 1:12417 BRANNER WAY APT 103
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2807
Mailing Address - Country:US
Mailing Address - Phone:804-647-2141
Mailing Address - Fax:
Practice Address - Street 1:12417 BRANNER WAY APT 103
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-2807
Practice Address - Country:US
Practice Address - Phone:804-647-2141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health