Healthcare Provider Details

I. General information

NPI: 1336766336
Provider Name (Legal Business Name): LIVING FAITH COMMUNITY HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 06/25/2020
Certification Date: 06/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10735 BRAES FOREST DR
HOUSTON TX
77071-1501
US

IV. Provider business mailing address

2626 RAVEN FALLS LN
FRIENDSWOOD TX
77546-6072
US

V. Phone/Fax

Practice location:
  • Phone: 832-326-9028
  • Fax:
Mailing address:
  • Phone: 832-326-9028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. VERONICA U OKAFOR
Title or Position: DIRECTOR
Credential:
Phone: 832-326-9028