Provider Demographics
NPI:1104643303
Name:FAITH IN FAITH
Entity type:Organization
Organization Name:FAITH IN FAITH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PRENTISS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:MEMBER
Authorized Official - Phone:262-417-5738
Mailing Address - Street 1:305 E PARK RD APT 112
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-7850
Mailing Address - Country:US
Mailing Address - Phone:262-417-5738
Mailing Address - Fax:
Practice Address - Street 1:305 E PARK RD APT 112
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-7850
Practice Address - Country:US
Practice Address - Phone:262-417-5738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care