Provider Demographics
NPI:1699152587
Name:FAITH HEALS INC
Entity type:Organization
Organization Name:FAITH HEALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:Q
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-316-9232
Mailing Address - Street 1:7325 NW 13TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-1252
Mailing Address - Country:US
Mailing Address - Phone:352-316-9232
Mailing Address - Fax:352-388-4880
Practice Address - Street 1:3501 NE 15TH ST
Practice Address - Street 2:W177
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-2473
Practice Address - Country:US
Practice Address - Phone:352-316-9232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL011683201Medicaid