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General NPI Number Information
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NPI Number | 1215225149
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Entity Type | Organization
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Legal Business Name | HOUSE OF FAITH LLC
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 07/12/2011
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Provider Practice Location Address
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Address Line | 928 HUNT ST
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City | JACKSON
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State | MS
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Zip | 39203-2908
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Country | US
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Telephone | 601-720-6692
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Fax |
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Provider Business Mailing Address
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Address Line | 120 FALCON RIDGE DR
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City | RAYMOND
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State | MS
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Zip | 39154-9613
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Country | US
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Telephone | 601-720-6692
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. FAITH A HADLEY
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Credential |
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Telephone | 601-720-6692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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