Provider Demographics
NPI:1790918977
Name:FAITH WORKS LLC
Entity Type:Organization
Organization Name:FAITH WORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:ARLENE
Authorized Official - Last Name:RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-831-9960
Mailing Address - Street 1:P.O. BOX 160
Mailing Address - Street 2:806 N. STATE ST.
Mailing Address - City:STANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48888
Mailing Address - Country:US
Mailing Address - Phone:989-831-9960
Mailing Address - Fax:989-831-8770
Practice Address - Street 1:806 N STATE ST.
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:MI
Practice Address - Zip Code:48888
Practice Address - Country:US
Practice Address - Phone:989-831-9960
Practice Address - Fax:989-831-8770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty