Healthcare Provider Details

I. General information

NPI: 1972436194
Provider Name (Legal Business Name): 1ST FAITH HOME CARE SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2049 HOUSTON ST
INDIANAPOLIS IN
46218-4407
US

IV. Provider business mailing address

2049 HOUSTON ST
INDIANAPOLIS IN
46218-4407
US

V. Phone/Fax

Practice location:
  • Phone: 463-271-9218
  • Fax: 317-982-7189
Mailing address:
  • Phone: 463-271-9218
  • Fax: 317-982-7189

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: ANGELA D M HALLIBURTON
Title or Position: CEO
Credential:
Phone: 463-271-9218