Provider Demographics
NPI:1538802947
Name:FAITH HOME HEALTH LLC
Entity type:Organization
Organization Name:FAITH HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TIERRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLUKER
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:214-301-4061
Mailing Address - Street 1:1801 E CAMELBACK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4165
Mailing Address - Country:US
Mailing Address - Phone:469-759-0441
Mailing Address - Fax:
Practice Address - Street 1:1801 E CAMELBACK RD STE 102
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4165
Practice Address - Country:US
Practice Address - Phone:469-759-0441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health