Provider Demographics
NPI:1134933088
Name:FAITHFUL SERVANTS
Entity type:Organization
Organization Name:FAITHFUL SERVANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUSSA
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:908-386-6331
Mailing Address - Street 1:90 BEAVER AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1017
Mailing Address - Country:US
Mailing Address - Phone:908-386-6331
Mailing Address - Fax:
Practice Address - Street 1:90 BEAVER AVE FL 2
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1017
Practice Address - Country:US
Practice Address - Phone:908-386-6331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care