MEDICARE: NURTURING BY FAITH HOME CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1598517922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NURTURING BY FAITH HOME CARE, LLC

Provider Business Mailing Address
First Line	:	6400 W MAIN ST STE 3H
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62223-3806
Country	:	US
Telephone Number	:	618-701-9085
Fax Number	:	618-213-6041

Provider Business Practice Location Address
First Line	:	6400 W MAIN ST STE 3H
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62223-3806
Country	:	US
Telephone Number	:	618-701-9085
Fax Number	:	618-213-6041

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	EBONY TRENEE WINTERS
Credential	:
Telephone Number	:	618-343-5057

Provider Enumeration Date	:	04/01/2024
Last Update Date	:	05/10/2026

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