Provider Demographics
NPI:1881319978
Name:GIFT OF FAITH, LLC ALF
Entity type:Organization
Organization Name:GIFT OF FAITH, LLC ALF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:561-633-1050
Mailing Address - Street 1:211 SILVER OAK RD NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-5582
Mailing Address - Country:US
Mailing Address - Phone:561-633-1050
Mailing Address - Fax:
Practice Address - Street 1:211 SILVER OAK RD NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-5582
Practice Address - Country:US
Practice Address - Phone:561-633-1050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility