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General NPI Number Information
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NPI Number | 1871360321
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Entity Type | Organization
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Legal Business Name | FAITH LIFE HOME CARE LLC
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Dates
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Enumeration Date | 12/05/2023
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 2520 GOLD HILL RD
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City | NEWCASTLE
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State | CA
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Zip | 95658-9688
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Country | US
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Telephone | 916-778-7704
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1144
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City | NEWCASTLE
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State | CA
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Zip | 95658-1144
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | SHAWN VARGAS
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Credential |
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Telephone | 916-778-7704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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