Healthcare Provider Details

I. General information

NPI: 1811431299
Provider Name (Legal Business Name): TRUTH FAITH 2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2016
Last Update Date: 12/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 MARTIN LUTHER KING DR
VILLE PLATTE LA
70586-4833
US

IV. Provider business mailing address

1021 MARTIN LUTHER KING DR
VILLE PLATTE LA
70586-4833
US

V. Phone/Fax

Practice location:
  • Phone: 337-363-4521
  • Fax: 337-363-4523
Mailing address:
  • Phone: 337-363-4521
  • Fax: 337-363-4523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateLA

VIII. Authorized Official

Name: MR. ARTHUR JAMES SAMPSON JR.
Title or Position: CHAIRMAN OF BOARD
Credential:
Phone: 337-363-4521