Healthcare Provider Details

I. General information

NPI: 1841395126
Provider Name (Legal Business Name): FAITH REGIONAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 10/10/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2622 W NORFOLK AVE STE 200
NORFOLK NE
68701-4423
US

IV. Provider business mailing address

PO BOX 869
NORFOLK NE
68702-0869
US

V. Phone/Fax

Practice location:
  • Phone: 402-644-7453
  • Fax: 402-644-7432
Mailing address:
  • Phone: 402-644-7249
  • Fax: 402-644-7432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number521001
License Number StateNE

VIII. Authorized Official

Name: KELLY A DRISCOLL
Title or Position: PRESIDENT/CEO
Credential:
Phone: 402-371-4880