MEDICARE: FAITHFUL HANDS SERVICES

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1639446792
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAITHFUL HANDS SERVICES

Provider Business Mailing Address
First Line	:	1625 SANDALWOOD PL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3639
Country	:	US
Telephone Number	:	615-678-3993
Fax Number	:

Provider Business Practice Location Address
First Line	:	1625 SANDALWOOD PL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3639
Country	:	US
Telephone Number	:	615-678-3993
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. MICHAEL JOSEPH DECLOUET
Credential	:
Telephone Number	:	615-678-3993

Provider Enumeration Date	:	11/17/2011
Last Update Date	:	11/17/2011

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