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General NPI Number Information
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NPI Number | 1073051918
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Entity Type | Organization
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Legal Business Name | FAITH HEALTH CARE CENTER
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Dates
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Enumeration Date | 02/10/2017
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 413 COMMONWEALTH AVE SUITE 7
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City | CATONSVILLE
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State | MD
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Zip | 21228-3044
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Country | US
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Telephone | 410-869-4602
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Fax |
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Provider Business Mailing Address
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Address Line | 413 COMMONWEALTH AVE SUITE 7
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City | CATONSVILLE
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State | MD
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Zip | 21228-3044
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Country | US
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Telephone | 410-869-4602
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MERCY FADOJU
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Credential |
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Telephone | 443-904-5129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R133965
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License Number State | MD
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