Provider Demographics
NPI:1609469543
Name:FAITH & HOPE INDEPENDENT LIVING HEALTH SERVICES OF MS INC.
Entity Type:Organization
Organization Name:FAITH & HOPE INDEPENDENT LIVING HEALTH SERVICES OF MS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGRUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-381-8584
Mailing Address - Street 1:737 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-3006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:737 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-3006
Practice Address - Country:US
Practice Address - Phone:769-524-6802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder