Provider Demographics
NPI:1578886495
Name:TRUTH FAITH HOMEHEATHCARE SYSTEM
Entity Type:Organization
Organization Name:TRUTH FAITH HOMEHEATHCARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHAUNTA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:281-431-9577
Mailing Address - Street 1:13702 RICHMOND AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-1870
Mailing Address - Country:US
Mailing Address - Phone:281-431-9577
Mailing Address - Fax:281-242-4975
Practice Address - Street 1:13702 RICHMOND AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-1870
Practice Address - Country:US
Practice Address - Phone:281-431-9577
Practice Address - Fax:281-242-4975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA700321251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health