Provider Demographics
NPI:1659618320
Name:FAITHFUL FRIENDS PERSONAL CARE SERVICES, LLC
Entity Type:Organization
Organization Name:FAITHFUL FRIENDS PERSONAL CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ELLISON
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:804-243-4040
Mailing Address - Street 1:13500 LAUGHTER CT
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-5218
Mailing Address - Country:US
Mailing Address - Phone:804-243-4040
Mailing Address - Fax:800-625-0441
Practice Address - Street 1:13500 LAUGHTER CT
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-5218
Practice Address - Country:US
Practice Address - Phone:804-243-4040
Practice Address - Fax:800-625-0441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-13917251E00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care