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General NPI Number Information
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NPI Number | 1285578559
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Entity Type | Organization
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Legal Business Name | FAITH FULFILLMENT CENTERS
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 120 SHADOW LAKE DR
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City | CONYERS
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State | GA
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Zip | 30094-4127
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Country | US
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Telephone | 404-396-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 120 SHADOW LAKE DR
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City | CONYERS
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State | GA
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Zip | 30094-4127
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Country | US
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Telephone | 404-396-8888
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SUNITA PATEL
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Credential |
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Telephone | 404-396-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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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 | 177F00000X
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Taxonomy Name | Lodging Provider
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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 | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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