Provider Demographics
NPI:1568110906
Name:A DEEPER FAITH HOME CARE
Entity Type:Organization
Organization Name:A DEEPER FAITH HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ELLIS
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC LCMHC
Authorized Official - Phone:704-451-5634
Mailing Address - Street 1:114 D AVE
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29532-4102
Mailing Address - Country:US
Mailing Address - Phone:704-451-5634
Mailing Address - Fax:
Practice Address - Street 1:114 D AVE
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-4102
Practice Address - Country:US
Practice Address - Phone:704-451-5634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health