Provider Demographics
NPI:1659158277
Name:CROWN OF FAITH & TRAINING LLC
Entity Type:Organization
Organization Name:CROWN OF FAITH & TRAINING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GEORGIAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-491-6748
Mailing Address - Street 1:131 CALEY AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-1608
Mailing Address - Country:US
Mailing Address - Phone:609-491-6748
Mailing Address - Fax:
Practice Address - Street 1:131 CALEY AVE
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-1608
Practice Address - Country:US
Practice Address - Phone:609-491-6748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health