Healthcare Provider Details

I. General information

NPI: 1225433253
Provider Name (Legal Business Name): FAITH WORKS ADULT DAY SUPPORT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2014
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1588 MOUNTAIN RD
GLEN ALLEN VA
23060-3915
US

IV. Provider business mailing address

1588 MOUNTAIN RD
GLEN ALLEN VA
23060-3915
US

V. Phone/Fax

Practice location:
  • Phone: 804-918-5928
  • Fax: 804-918-5931
Mailing address:
  • Phone: 804-918-5928
  • Fax: 804-918-5931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTI NICOLE WALKER
Title or Position: DIRECTOR/OWNER
Credential: RN
Phone: 804-363-8373