Provider Demographics
NPI:1659135754
Name:FAITH JOURNEY HOME CARE LLC
Entity type:Organization
Organization Name:FAITH JOURNEY HOME CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-500-4657
Mailing Address - Street 1:3640 S PLAZA TRL STE 201B
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-3363
Mailing Address - Country:US
Mailing Address - Phone:757-500-4657
Mailing Address - Fax:757-937-7168
Practice Address - Street 1:3640 S PLAZA TRL STE 201B
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-3363
Practice Address - Country:US
Practice Address - Phone:757-500-4657
Practice Address - Fax:757-937-7168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty