Healthcare Provider Details

I. General information

NPI: 1346964509
Provider Name (Legal Business Name): FAITHFUL HEART AND HANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2022
Last Update Date: 09/30/2022
Certification Date: 09/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12058 S BROADWAY
LOS ANGELES CA
90061-1337
US

IV. Provider business mailing address

12058 S BROADWAY
LOS ANGELES CA
90061-1337
US

V. Phone/Fax

Practice location:
  • Phone: 132-350-6174
  • Fax:
Mailing address:
  • Phone: 132-350-6174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FAITH LAMB
Title or Position: OWNER
Credential:
Phone: 323-506-1743