Provider Demographics
NPI:1558115030
Name:FAITHFULNESS CARE LLC
Entity Type:Organization
Organization Name:FAITHFULNESS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALECIA
Authorized Official - Middle Name:MANDELA
Authorized Official - Last Name:MALLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-356-5453
Mailing Address - Street 1:835 NW 168TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5326
Mailing Address - Country:US
Mailing Address - Phone:754-226-3788
Mailing Address - Fax:954-708-1287
Practice Address - Street 1:3363 NE 163RD ST STE 806D
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4438
Practice Address - Country:US
Practice Address - Phone:754-226-3788
Practice Address - Fax:954-708-1281
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAITHFULNESS CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-12
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care