Provider Demographics
NPI:1841798329
Name:FAITH WORKS FOUNDATION
Entity Type:Organization
Organization Name:FAITH WORKS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:CHERIE
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS-A
Authorized Official - Phone:704-430-1038
Mailing Address - Street 1:13724 RIDING HILL AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4251
Mailing Address - Country:US
Mailing Address - Phone:704-430-1038
Mailing Address - Fax:704-336-8506
Practice Address - Street 1:610 E 7TH ST STE 103
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2923
Practice Address - Country:US
Practice Address - Phone:980-256-4357
Practice Address - Fax:704-336-8506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty