Provider Demographics
NPI:1346445707
Name:LLC FAITH CARING HOME HEALTH SERVICES
Entity type:Organization
Organization Name:LLC FAITH CARING HOME HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, CHIEF OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DOUYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-768-4797
Mailing Address - Street 1:3617 RIDGE BROOK TRL
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-6895
Mailing Address - Country:US
Mailing Address - Phone:678-768-4797
Mailing Address - Fax:
Practice Address - Street 1:3617 RIDGE BROOK TRL
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-6895
Practice Address - Country:US
Practice Address - Phone:678-768-4797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-17
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No251E00000XAgenciesHome Health