Provider Demographics
NPI:1629274584
Name:FAITH & SPIRIT, INC. DBA RIGHT AT HOME
Entity Type:Organization
Organization Name:FAITH & SPIRIT, INC. DBA RIGHT AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:DYCK
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-460-4848
Mailing Address - Street 1:PO BOX 64308
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98464-0308
Mailing Address - Country:US
Mailing Address - Phone:253-460-4848
Mailing Address - Fax:253-460-4949
Practice Address - Street 1:1702 S 72ND ST
Practice Address - Street 2:SUITE E
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-1238
Practice Address - Country:US
Practice Address - Phone:253-460-4848
Practice Address - Fax:253-460-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIS-146302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization