Provider Demographics
NPI:1316785694
Name:FAITH TRANSPORT & COMPANION SERVICES, LLC
Entity type:Organization
Organization Name:FAITH TRANSPORT & COMPANION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WESDYDA
Authorized Official - Middle Name:DORIVAL
Authorized Official - Last Name:GASSANT
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:678-330-8054
Mailing Address - Street 1:1623 GREAT SHOALS CIRCLE
Mailing Address - Street 2:LAWRENCEVILLE
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045
Mailing Address - Country:US
Mailing Address - Phone:678-330-8054
Mailing Address - Fax:404-300-9617
Practice Address - Street 1:1623 GREAT SHOALS CIRCLE
Practice Address - Street 2:LAWRENCEVILLE
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045
Practice Address - Country:US
Practice Address - Phone:678-330-8054
Practice Address - Fax:404-300-9617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty