Provider Demographics
NPI:1770194102
Name:LIVING FAITH HOME CARE LLC
Entity Type:Organization
Organization Name:LIVING FAITH HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:OBAROGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:164-623-9739
Mailing Address - Street 1:1532 STEWART DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6599
Mailing Address - Country:US
Mailing Address - Phone:646-239-7393
Mailing Address - Fax:
Practice Address - Street 1:1532 STEWART DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6599
Practice Address - Country:US
Practice Address - Phone:646-239-7393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80376844OtherMEDICAID