Provider Demographics
NPI:1013248657
Name:FAITH HOPE & CHARITY FH&C SUPPORTIVE LIVING INC
Entity Type:Organization
Organization Name:FAITH HOPE & CHARITY FH&C SUPPORTIVE LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-793-4066
Mailing Address - Street 1:3344 MARINA RD
Mailing Address - Street 2:APARTMENT # 211
Mailing Address - City:SOUTH MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53172-3961
Mailing Address - Country:US
Mailing Address - Phone:414-793-4066
Mailing Address - Fax:847-239-7694
Practice Address - Street 1:3344 MARINA RD
Practice Address - Street 2:APARTMENT # 211
Practice Address - City:SOUTH MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53172-3961
Practice Address - Country:US
Practice Address - Phone:414-793-4066
Practice Address - Fax:847-239-7694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR34233311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home