Provider Demographics
NPI:1982940789
Name:FAITHFUL AT HOME CARE LLC
Entity type:Organization
Organization Name:FAITHFUL AT HOME CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DEBASISH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-431-1211
Mailing Address - Street 1:888 MILLERSVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603
Mailing Address - Country:US
Mailing Address - Phone:717-431-1211
Mailing Address - Fax:717-431-1240
Practice Address - Street 1:888 MILLERSVILLE ROAD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603
Practice Address - Country:US
Practice Address - Phone:717-431-1211
Practice Address - Fax:717-431-1240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA23663601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23663601Medicaid