Provider Demographics
NPI:1285238758
Name:FAITHFUL FRIENDS LOVING CARE ASSISTED LIVING CORPORATION
Entity type:Organization
Organization Name:FAITHFUL FRIENDS LOVING CARE ASSISTED LIVING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTHE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLAURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-237-8174
Mailing Address - Street 1:323 49TH AVE ST NW
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209
Mailing Address - Country:US
Mailing Address - Phone:941-237-8174
Mailing Address - Fax:
Practice Address - Street 1:323 49TH ST NW
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-1922
Practice Address - Country:US
Practice Address - Phone:941-237-8174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness