Provider Demographics
NPI:1609348861
Name:FAITH VISION INC
Entity Type:Organization
Organization Name:FAITH VISION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:702-205-3417
Mailing Address - Street 1:700 W VAN BUREN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3043
Mailing Address - Country:US
Mailing Address - Phone:702-205-3417
Mailing Address - Fax:
Practice Address - Street 1:2323 PALOMINO LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-4503
Practice Address - Country:US
Practice Address - Phone:702-205-3417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility