Healthcare Provider Details

I. General information

NPI: 1588342398
Provider Name (Legal Business Name): THE BY FAITH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 W EVANS ST
FLORENCE SC
29501-3441
US

IV. Provider business mailing address

PO BOX 491
NASHVILLE NC
27856-0491
US

V. Phone/Fax

Practice location:
  • Phone: 843-799-0327
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SABRENA PITTMAN
Title or Position: OWNER
Credential:
Phone: 843-799-0327