Provider Demographics
NPI:1265772685
Name:FAITH AND HOPE INDEPENDENT LIVING
Entity type:Organization
Organization Name:FAITH AND HOPE INDEPENDENT LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KULMORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-807-5496
Mailing Address - Street 1:232 MARKET ST
Mailing Address - Street 2:BLDG K 2ND LEVEL STE. 208
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-3339
Mailing Address - Country:US
Mailing Address - Phone:601-951-5667
Mailing Address - Fax:601-914-7228
Practice Address - Street 1:408 THATCHER LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-6516
Practice Address - Country:US
Practice Address - Phone:318-450-1478
Practice Address - Fax:318-388-6893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based