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General NPI Number Information
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NPI Number | 1245337948
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Entity Type | Organization
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Legal Business Name | FAITH HOME CARE SERVICES
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 04/29/2011
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Provider Practice Location Address
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Address Line | 1010 LORELEI
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City | ZION
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State | IL
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Zip | 60099-1368
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Country | US
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Telephone | 224-610-0434
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Fax | 708-589-4349
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Provider Business Mailing Address
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Address Line | 1010 LORELEI DR
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City | ZION
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State | IL
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Zip | 60099-1368
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Country | US
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Telephone | 224-610-0434
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Fax | 708-589-4349
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Authorized Official
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Title or Position | EXECUTIVE ADMINISTRATOR
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Name | MS. OPAL MULLINGS
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Credential |
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Telephone | 224-610-0434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 6391-153-4
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License Number State | IL
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