Healthcare Provider Details

I. General information

NPI: 1043732738
Provider Name (Legal Business Name): BY FAITH HOMEMAKER & COMPANION SERVICES,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 PRINCESS LUISE LN
PALM COAST FL
32164-7123
US

IV. Provider business mailing address

22 PRINCESS LUISE LN
PALM COAST FL
32164-7123
US

V. Phone/Fax

Practice location:
  • Phone: 386-627-5921
  • Fax: 866-728-3578
Mailing address:
  • Phone: 386-627-5921
  • Fax: 866-728-3578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. TARSHA P MCGLOCKING
Title or Position: OWNER
Credential:
Phone: 386-627-5921