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General NPI Number Information
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NPI Number | 1912748211
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Entity Type | Organization
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Legal Business Name | FAITH HEALTHCARE AND HEALING, LLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 610 1/2
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City | POINT PLEASANT
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State | WV
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Zip | 25550-1121
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Country | US
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Telephone | 304-812-5426
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Fax | 304-812-5427
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Provider Business Mailing Address
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Address Line | 8674 BLACK OAK ROAD
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City | FRAZIERS BOTTOM
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State | WV
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Zip | 25082
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Country | US
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Telephone | 304-812-5426
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Fax | 304-812-5427
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | JESSICA QUEEN
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Credential |
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Telephone | 304-812-5426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 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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