Healthcare Provider Details

I. General information

NPI: 1558600759
Provider Name (Legal Business Name): FAITHFUL NURSES HOME HEALTH CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 02/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 STEVE WAY
NOTTINGHAM MD
21236-1540
US

IV. Provider business mailing address

3 STEVE WAY
NOTTINGHAM MD
21236-1540
US

V. Phone/Fax

Practice location:
  • Phone: 609-220-0432
  • Fax: 410-529-1139
Mailing address:
  • Phone: 609-220-0432
  • Fax: 410-529-1139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR3402P
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberR3402P
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberR3402P
License Number StateMD

VIII. Authorized Official

Name: MRS. JANE EUNICE ANYANGO OWADE
Title or Position: DON/ADMINISTRATOR
Credential: RN
Phone: 609-220-0432