Provider Demographics
NPI:1487935417
Name:FAITH HEALTH CARE CENTER
Entity type:Organization
Organization Name:FAITH HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNP
Authorized Official - Prefix:
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:FADOJU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-904-5129
Mailing Address - Street 1:413 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3044
Mailing Address - Country:US
Mailing Address - Phone:443-904-5129
Mailing Address - Fax:410-747-4000
Practice Address - Street 1:413 COMMONWEALTH AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-3044
Practice Address - Country:US
Practice Address - Phone:443-904-5129
Practice Address - Fax:410-747-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-03
Last Update Date:2011-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDW14256937261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service