Healthcare Provider Details

I. General information

NPI: 1417607912
Provider Name (Legal Business Name): FAITH, HOPE & HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2022
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17933 NW EVERGREEN PL STE 111
BEAVERTON OR
97006-7531
US

IV. Provider business mailing address

3159 CARPENTERS PARK RD
DAVIDSVILLE PA
15928-9223
US

V. Phone/Fax

Practice location:
  • Phone: 814-243-0414
  • Fax: 814-479-5906
Mailing address:
  • Phone: 814-243-0414
  • Fax: 814-479-5906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA GRIESHEIMER
Title or Position: COO
Credential: CBCS
Phone: 814-243-0414