Provider Demographics
NPI:1578329694
Name:FAITHFUL SERVANTS CARE, LLC
Entity Type:Organization
Organization Name:FAITHFUL SERVANTS CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:SKELTON
Authorized Official - Last Name:AINSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-558-0303
Mailing Address - Street 1:304 GRIGGS ACRES DR
Mailing Address - Street 2:
Mailing Address - City:POINT HARBOR
Mailing Address - State:NC
Mailing Address - Zip Code:27964-9722
Mailing Address - Country:US
Mailing Address - Phone:252-558-0303
Mailing Address - Fax:804-302-4474
Practice Address - Street 1:304 GRIGGS ACRES DR
Practice Address - Street 2:
Practice Address - City:POINT HARBOR
Practice Address - State:NC
Practice Address - Zip Code:27964-9722
Practice Address - Country:US
Practice Address - Phone:252-558-0303
Practice Address - Fax:804-302-4474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1306388483Medicaid