Provider Demographics
NPI:1770934192
Name:FAITH HOME HEALTH
Entity type:Organization
Organization Name:FAITH HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNSON
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOBASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-221-5399
Mailing Address - Street 1:9319 LBJ FWY
Mailing Address - Street 2:SUITE 217B
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3450
Mailing Address - Country:US
Mailing Address - Phone:214-221-5399
Mailing Address - Fax:214-221-0330
Practice Address - Street 1:9319 LBJ FWY
Practice Address - Street 2:SUITE 217B
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3450
Practice Address - Country:US
Practice Address - Phone:214-221-5399
Practice Address - Fax:214-221-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health