Healthcare Provider Details

I. General information

NPI: 1649406596
Provider Name (Legal Business Name): FAITH AND HOPE IND LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 06/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 THATCHER LN
MONROE LA
71203-6516
US

IV. Provider business mailing address

408 THATCHER LN
MONROE LA
71203-6516
US

V. Phone/Fax

Practice location:
  • Phone: 318-388-6808
  • Fax: 318-388-6893
Mailing address:
  • Phone: 318-388-6808
  • Fax: 318-388-6893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number1328341
License Number StateLA

VIII. Authorized Official

Name: MR. NEAL ANGRUM
Title or Position: DIRECTOR
Credential:
Phone: 318-450-1478