=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336667401
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEPPING STONES OF FAITH CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2017
-----------------------------------------------------
Last Update Date | 09/08/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20834 COCHRAN RD
-----------------------------------------------------
City | HEMPSTEAD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77445-8510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-218-9014
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 492
-----------------------------------------------------
City | PRAIRIE VIEW
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77446-0492
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-218-9014
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | CHERISE DAVENA WILLIAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 936-218-9014
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------