Provider Demographics
NPI:1689905168
Name:FAITH CONNECTIONS HOME HEALTH AND PROFESSIONAL SERVICE CORPORATION
Entity Type:Organization
Organization Name:FAITH CONNECTIONS HOME HEALTH AND PROFESSIONAL SERVICE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:708-590-9508
Mailing Address - Street 1:15335 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419-3110
Mailing Address - Country:US
Mailing Address - Phone:708-590-9508
Mailing Address - Fax:
Practice Address - Street 1:15335 SUNSET DR
Practice Address - Street 2:
Practice Address - City:DOLTON
Practice Address - State:IL
Practice Address - Zip Code:60419
Practice Address - Country:US
Practice Address - Phone:708-590-9508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health