Healthcare Provider Details

I. General information

NPI: 1912930447
Provider Name (Legal Business Name): FAITHFUL FRIENDS HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 E MAIN ST
GAS CITY IN
46933-1458
US

IV. Provider business mailing address

326 E MAIN ST
GAS CITY IN
46933-1458
US

V. Phone/Fax

Practice location:
  • Phone: 765-674-7066
  • Fax: 765-674-7101
Mailing address:
  • Phone: 765-674-7066
  • Fax: 765-674-7101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JODY LYNN HAMBLIN
Title or Position: OFFICE MANAGER
Credential:
Phone: 765-674-7066