Provider Demographics
NPI:1356981047
Name:FAITH AND FAMILY HOME CARE LLC
Entity type:Organization
Organization Name:FAITH AND FAMILY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-622-3962
Mailing Address - Street 1:4160 LOGAN DR UNIT 52
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-9500
Mailing Address - Country:US
Mailing Address - Phone:470-622-3962
Mailing Address - Fax:
Practice Address - Street 1:3339 GARDENSIDE WALK
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-7905
Practice Address - Country:US
Practice Address - Phone:786-376-1360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-09
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty