Provider Demographics
NPI:1639338643
Name:GOOD FAITH HOME HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:GOOD FAITH HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:C
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-277-1725
Mailing Address - Street 1:3948 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-1511
Mailing Address - Country:US
Mailing Address - Phone:907-277-1725
Mailing Address - Fax:907-277-0976
Practice Address - Street 1:3948 MOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-1511
Practice Address - Country:US
Practice Address - Phone:907-277-1725
Practice Address - Fax:907-277-0976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK909163251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health