Healthcare Provider Details

I. General information

NPI: 1093460446
Provider Name (Legal Business Name): GOOD FAITH CARE INC DBA GOOD FAITH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 02/15/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

786 SILAS DEANE HWY
WETHERSFIELD CT
06109-3071
US

IV. Provider business mailing address

786 SILAS DEANE HWY
WETHERSFIELD CT
06109-3071
US

V. Phone/Fax

Practice location:
  • Phone: 860-785-8162
  • Fax:
Mailing address:
  • Phone: 860-785-8162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MALLIKA BUDHAI
Title or Position: MEMBER
Credential:
Phone: 860-785-8162