Provider Demographics
NPI:1811572712
Name:GOOD FAITH HOME CARE LLC
Entity type:Organization
Organization Name:GOOD FAITH HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEDLEY
Authorized Official - Middle Name:K
Authorized Official - Last Name:FLEURICOURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-255-2986
Mailing Address - Street 1:1903 BRANDON BROOK RD
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-3025
Mailing Address - Country:US
Mailing Address - Phone:813-564-0500
Mailing Address - Fax:
Practice Address - Street 1:1903 BRANDON BROOK RD
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-3025
Practice Address - Country:US
Practice Address - Phone:813-564-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health