Provider Demographics
NPI:1699282269
Name:ACTS OF FAITH, INC.
Entity type:Organization
Organization Name:ACTS OF FAITH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUTHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-982-2150
Mailing Address - Street 1:1427 W 86TH ST # 618
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2103
Mailing Address - Country:US
Mailing Address - Phone:317-982-2150
Mailing Address - Fax:
Practice Address - Street 1:2440 LAFAYETTE RD STE 1A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-2152
Practice Address - Country:US
Practice Address - Phone:317-982-2150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17-04156-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health