Provider Demographics
NPI:1962837955
Name:HOPEN FAITH HOME CARE
Entity Type:Organization
Organization Name:HOPEN FAITH HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:WEBBER
Authorized Official - Suffix:
Authorized Official - Credentials:07/10/1965
Authorized Official - Phone:901-864-8551
Mailing Address - Street 1:3222 THIRTEEN COLONY MALL
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-2985
Mailing Address - Country:US
Mailing Address - Phone:901-864-8551
Mailing Address - Fax:901-791-4427
Practice Address - Street 1:3222 THIRTEEN COLONY MALL
Practice Address - Street 2:SUITE 4
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-2985
Practice Address - Country:US
Practice Address - Phone:901-864-8551
Practice Address - Fax:901-791-4427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN113003017253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care