Provider Demographics
NPI:1902320815
Name:LIVING BY FAITH INC.
Entity Type:Organization
Organization Name:LIVING BY FAITH INC.
Other - Org Name:LIVING BY FAITH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINSTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-456-3725
Mailing Address - Street 1:905 NE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2693
Mailing Address - Country:US
Mailing Address - Phone:954-456-3725
Mailing Address - Fax:844-319-1193
Practice Address - Street 1:905 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2693
Practice Address - Country:US
Practice Address - Phone:954-456-3725
Practice Address - Fax:844-319-1193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12854310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021063000Medicaid