Provider Demographics
NPI:1639797442
Name:WALK BY FAITH NOT BY SIGHT HOMECARE
Entity Type:Organization
Organization Name:WALK BY FAITH NOT BY SIGHT HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING
Authorized Official - Prefix:MS
Authorized Official - First Name:FELECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-899-2445
Mailing Address - Street 1:2310 US-80 WEST
Mailing Address - Street 2:SUITE F 1154
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39204
Mailing Address - Country:US
Mailing Address - Phone:601-321-9399
Mailing Address - Fax:601-665-4815
Practice Address - Street 1:2310 US-80 WEST
Practice Address - Street 2:SUITE F 1154
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204
Practice Address - Country:US
Practice Address - Phone:601-321-9399
Practice Address - Fax:601-665-4815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty