Provider Demographics
NPI:1790081925
Name:FAITH HOME CARE SERVICES, INC
Entity Type:Organization
Organization Name:FAITH HOME CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-742-4845
Mailing Address - Street 1:7282 NOTTINGHAMSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32219-4323
Mailing Address - Country:US
Mailing Address - Phone:904-742-4845
Mailing Address - Fax:904-302-8051
Practice Address - Street 1:7282 NOTTINGHAMSHIRE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32219-4323
Practice Address - Country:US
Practice Address - Phone:904-742-4845
Practice Address - Fax:904-302-8051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-05
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health