Provider Demographics
NPI:1639446792
Name:FAITHFUL HANDS SERVICES
Entity Type:Organization
Organization Name:FAITHFUL HANDS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DECLOUET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-678-3993
Mailing Address - Street 1:1625 SANDALWOOD PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3639
Mailing Address - Country:US
Mailing Address - Phone:615-678-3993
Mailing Address - Fax:
Practice Address - Street 1:1625 SANDALWOOD PL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3639
Practice Address - Country:US
Practice Address - Phone:615-678-3993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health