Provider Demographics
NPI:1396153482
Name:FAITHWORKS, INC.
Entity type:Organization
Organization Name:FAITHWORKS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:FODAY
Authorized Official - Suffix:
Authorized Official - Credentials:BA,MA
Authorized Official - Phone:512-648-9947
Mailing Address - Street 1:11424 OXFORDSHIRE LN
Mailing Address - Street 2:LEVEL B
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-2813
Mailing Address - Country:US
Mailing Address - Phone:513-371-1195
Mailing Address - Fax:513-648-9926
Practice Address - Street 1:11424 OXFORDSHIRE LN # LANEB
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-2813
Practice Address - Country:US
Practice Address - Phone:513-371-1195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3110001253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3110001Medicaid