Healthcare Provider Details

I. General information

NPI: 1548603202
Provider Name (Legal Business Name): OUR FUTURE FAITH & FAMILY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2013
Last Update Date: 03/28/2024
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 GELSINGER AVE
BESSEMER CITY NC
28016-6814
US

IV. Provider business mailing address

2020 REMOUNT RD STE 100
GASTONIA NC
28054-7478
US

V. Phone/Fax

Practice location:
  • Phone: 704-460-1687
  • Fax:
Mailing address:
  • Phone: 704-460-1687
  • Fax: 908-553-2015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANGELA KAYE HOUSER
Title or Position: EXECUTIVE DIRECTOR
Credential: MS,LCAS
Phone: 704-460-1687