Provider Demographics
NPI:1811131675
Name:GOOD FAITH INC
Entity type:Organization
Organization Name:GOOD FAITH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MINIRU
Authorized Official - Middle Name:OMOTAYO
Authorized Official - Last Name:ALAWIYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-438-2936
Mailing Address - Street 1:6040 EARLE BROWN DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2514
Mailing Address - Country:US
Mailing Address - Phone:763-208-9272
Mailing Address - Fax:763-503-9451
Practice Address - Street 1:6500 BROOKLYN BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-1754
Practice Address - Country:US
Practice Address - Phone:763-438-2936
Practice Address - Fax:763-503-9451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health