Healthcare Provider Details

I. General information

NPI: 1083252324
Provider Name (Legal Business Name): FAITH CARES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2019
Last Update Date: 12/30/2019
Certification Date: 12/30/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9633 SIL ST
TAYLOR MI
48180-3028
US

IV. Provider business mailing address

9633 SIL ST
TAYLOR MI
48180-3028
US

V. Phone/Fax

Practice location:
  • Phone: 313-854-3148
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: PATIENCE EKOGIAWE
Title or Position: PRESIDENT
Credential:
Phone: 313-854-3148