Healthcare Provider Details

I. General information

NPI: 1174896526
Provider Name (Legal Business Name): FAITHFUL CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1762 DALLAS DR
BATON ROUGE LA
70806-1438
US

IV. Provider business mailing address

1762 DALLAS DR
BATON ROUGE LA
70806-1438
US

V. Phone/Fax

Practice location:
  • Phone: 225-288-7555
  • Fax:
Mailing address:
  • Phone: 225-288-7555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN WILSON
Title or Position: OWNER
Credential:
Phone: 225-288-7555