MEDICARE: FAITH WAY RESIDENTIAL LIVING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1447422068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAITH WAY RESIDENTIAL LIVING

Provider Business Mailing Address
First Line	:	5360 COLTON DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-1412
Country	:	US
Telephone Number	:	314-398-4940
Fax Number	:	314-385-2032

Provider Business Practice Location Address
First Line	:	5360 COLTON DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-1412
Country	:	US
Telephone Number	:	314-398-4940
Fax Number	:	314-385-2032

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ROSE M. FRANKLIN
Credential	:
Telephone Number	:	314-398-4940

Provider Enumeration Date	:	03/25/2008
Last Update Date	:	03/25/2008

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Directions to “FAITH WAY RESIDENTIAL LIVING ” Practice Location

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