Faith Hospice Care LLC
Organization Active NPI Community Based Hospice Care Agency · Fairfield, NJ
NPI 1003695370 · NPPES record last updated Jun 18, 2025
Key facts
- NPI
- 1003695370
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- FAITH HOSPICE CARE LLC
- Practice address
- 383 US Highway 46 Ste 302
Fairfield, NJ 07004-2473 - Phone
- (973) 244-2480
- Fax
- (973) 629-1654
- NPI assigned
- Sep 26, 2023
- Organization subpart
- No
Authorized official
- Name
- Geetakumari B Fofandi
- Title
- Ceo
- Phone
- (973) 244-2480
Owners & managing parties with NPI records 3
-
Sanjay R Shah, MD. MBBS
Member of 1
Affiliated clinicians 7
-
Toufiq Imtiaz, MD
-
Sanjay R Shah, MD. MBBS
-
Ishak G Soliman, M.D.
-
Shiraz Cede Yussaf, M.D
Medicare Care Compare: Hospice
- Listed as
- Faith Hospice Care LLC
- Certified
- Oct 21, 2024
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D2295840 | Faith Hospice Care LLC | Certificate of waiver | Dec 17, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Hospice certification: CCN 311598
- Legal name
- FAITH HOSPICE CARE LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Oct 21, 2024
- Last certification
- Oct 4, 2024
- Ownership / control type
- Proprietary - Other
- Organization structure
- LLC · Proprietary
- Incorporated
- Sep 29, 2023 in NJ
- Enrollment address
- 383 US Highway 46
Ste 302
Fairfield, NJ 07004-2473
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Faith Home Healthcare LLC |
5% Or Greater Direct Ownership Interest | Sep 23, 2024 | 100% |
| Namrata Patel |
5% Or Greater Indirect Ownership Interest | Sep 29, 2023 | 30% |
| Sanjay R Shah |
W-2 Managing Employee |
Jan 31, 2025 | |
| Geetakumari Fofandi |
5% Or Greater Indirect Ownership Interest | Sep 29, 2023 | 51% |
| Corporate Director |
Apr 19, 2024 | 25% | |
| W-2 Managing Employee |
Apr 19, 2024 | 25% | |
| Chaitalibahen Patel |
Corporate Director |
Apr 19, 2024 | 25% |
| Ketty Davila |
W-2 Managing Employee |
Jan 30, 2025 | |
| Tasha Godbolt |
W-2 Managing Employee |
Apr 19, 2024 | 25% |
| Mamtaben Patel |
5% Or Greater Indirect Ownership Interest | Sep 29, 2023 | 19% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240618002550 | NJ | Part a Provider - Hospice | 0244773299 | Practice locations: Fairfield, NJ |
National Provider Directory
Locations
271 US Highway 46
Ste H208
Fairfield, NJ 07004
Phone (973) 244-2480
383 US Highway 46
Ste 302
Fairfield, NJ 07004
Phone (973) 244-2480
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
383 US Highway 46 Ste 302
Fairfield, NJ 07004-2473
Mailing address
383 US Highway 46 Ste 302
Fairfield, NJ 07004-2473
Phone (973) 244-2480
Other names
- Faith Hospice Care
Other providers in Fairfield, NJ
- Fairfield Vol Fire Co No1
- Fairfield Wellness and Physical Therapy, LLC
- Faith Home Healthcare LLC
- Faith Home Healthcare LLC
- Faith Home Healthcare LLC
- Thomas Fedak
- Fedcap Rehabilitation Services, Inc.
- Marjorie M Feldman
- Alexis Ferguson
- Gabriella Ferrovecchio
All providers in Fairfield, NJ · Community Based Hospice Care Agency in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.