Provider Demographics
NPI:1689436875
Name:ROYAL FAITH HOMECARE AGENCY LLC
Entity Type:Organization
Organization Name:ROYAL FAITH HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:COURTNEY
Authorized Official - Last Name:MITTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-778-6519
Mailing Address - Street 1:107 COLONY PARK DR STE 700C
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2788
Mailing Address - Country:US
Mailing Address - Phone:470-840-8480
Mailing Address - Fax:
Practice Address - Street 1:107 COLONY PARK DR STE 700C
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2788
Practice Address - Country:US
Practice Address - Phone:470-840-8480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health