Provider Demographics
NPI:1679152250
Name:FAITH LIVING SENIOR HOME CARE
Entity Type:Organization
Organization Name:FAITH LIVING SENIOR HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERLYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:754-246-2349
Mailing Address - Street 1:902 PALLADIO PL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5750
Mailing Address - Country:US
Mailing Address - Phone:210-993-2120
Mailing Address - Fax:
Practice Address - Street 1:902 PALLADIO PL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-5750
Practice Address - Country:US
Practice Address - Phone:210-993-2120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No385H00000XRespite Care FacilityRespite Care