Provider Demographics
NPI:1538439336
Name:FAITH, HOPE AND LOVE ADULT FAMILY CARE HOME
Entity type:Organization
Organization Name:FAITH, HOPE AND LOVE ADULT FAMILY CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LURINE
Authorized Official - Middle Name:ALVINA
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-879-3333
Mailing Address - Street 1:PO BOX 691625
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869-1625
Mailing Address - Country:US
Mailing Address - Phone:407-879-3333
Mailing Address - Fax:407-325-5540
Practice Address - Street 1:5520 RIDGEWAY DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7435
Practice Address - Country:US
Practice Address - Phone:407-879-3333
Practice Address - Fax:407-352-5540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906513251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health