Provider Demographics
NPI:1114764578
Name:FAITH FAMILY PRACTICE AND WELLNESS CENTER LLC
Entity type:Organization
Organization Name:FAITH FAMILY PRACTICE AND WELLNESS CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KARANJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-940-7780
Mailing Address - Street 1:13 MARTIN LN
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17579-9742
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1335 MEADOWCREEK LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4615
Practice Address - Country:US
Practice Address - Phone:717-940-7780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty