Provider Demographics
NPI:1639523715
Name:FAITH STANDARD HEALTH SERVICES; LLC
Entity Type:Organization
Organization Name:FAITH STANDARD HEALTH SERVICES; LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:TAKANG
Authorized Official - Last Name:TABENYANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-605-7229
Mailing Address - Street 1:808 BUSLEIGH CASTLE WAY
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-7468
Mailing Address - Country:US
Mailing Address - Phone:469-605-7229
Mailing Address - Fax:512-770-6414
Practice Address - Street 1:808 BUSLEIGH CASTLE WAY
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7468
Practice Address - Country:US
Practice Address - Phone:469-605-7229
Practice Address - Fax:512-770-6414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016573251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health