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General NPI Number Information
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NPI Number | 1396976775
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Entity Type | Organization
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Legal Business Name | THE GREATER FAITH HOME CARE
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 108 N ADAMS ST
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City | DURHAM
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State | NC
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Zip | 27703-3304
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Country | US
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Telephone | 919-451-2773
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Fax | 919-596-1891
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Provider Business Mailing Address
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Address Line | 7403 CHESLEY LN
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City | DURHAM
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State | NC
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Zip | 27713-7216
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Country | US
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Telephone | 919-451-2773
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Fax | 919-596-1891
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANNIE MCKOY
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Credential |
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Telephone | 919-451-2773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | MHL-032-474
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License Number State | NC
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