Provider Demographics
NPI:1962202085
Name:FAITHFUL GROUP HOME, LLC
Entity type:Organization
Organization Name:FAITHFUL GROUP HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHIZI
Authorized Official - Suffix:
Authorized Official - Credentials:MHAN
Authorized Official - Phone:603-848-7760
Mailing Address - Street 1:15 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:GOFFSTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03045-3003
Mailing Address - Country:US
Mailing Address - Phone:603-848-7760
Mailing Address - Fax:603-848-7760
Practice Address - Street 1:15 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:GOFFSTOWN
Practice Address - State:NH
Practice Address - Zip Code:03045-3003
Practice Address - Country:US
Practice Address - Phone:603-848-7760
Practice Address - Fax:603-848-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging