Organization · NPI-2

Faith Independence 3a INC

Home Health · Ocoee, FL

NPI number1205508314
StatusActive
Last updated in NPPESSep 28, 2021

Details

NPI
1205508314
Entity type
Organization (NPI-2)
Legal business name
Faith Independence 3a INC
Organization subpart
No
Enumeration date
Sep 28, 2021
Certification date
Sep 28, 2021
Last updated
Sep 28, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home Health––Yes

Practice location

456 Canby Cir
Ocoee, FL 34761-8903

Phone 407-309-0481 · Fax 407-641-9799

Mailing address

456 Canby Cir
Ocoee, FL 34761-8903

Phone 407-309-0481 · Fax 407-641-9799

Authorized official

Lue Jimmie Fillicia Johnson
Owner
4073090481

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