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General NPI Number Information
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NPI Number | 1699255604
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Entity Type | Organization
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Legal Business Name | FAITHFUL CAREGIVERS,LLC
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Dates
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Enumeration Date | 08/19/2018
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Last Update Date | 08/19/2018
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Provider Practice Location Address
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Address Line | 1501 RIDGEWOOD AVE STE 207
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City | HOLLY HILL
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State | FL
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Zip | 32117-2257
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Country | US
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Telephone | 386-852-7464
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Fax | 386-333-9348
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Provider Business Mailing Address
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Address Line | 1501 RIDGEWOOD AVE STE 207
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City | HOLLY HILL
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State | FL
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Zip | 32117-2257
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Country | US
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Telephone | 386-852-7464
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Fax | 386-333-9348
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR/DON
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Name | MRS. SHARLENE BARHOO
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Credential | RN.BC
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Telephone | 386-852-7464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 30211987
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License Number State | FL
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