Faith Group Home Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

FAITH GROUP HOME INC.

Practice address

836 W Desoto St Ste 5E
Clermont, FL 34711-2110

Phone

(352) 396-1247

Fax

(352) 394-2353

NPI assigned

Oct 28, 2021

Last updated

Oct 28, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Roderick Larow Roberson

Title

Owner

Phone

(352) 396-1247

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Faith Group Home Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Faith Group Home Inc.

  • Home Health Agency
  • Clermont, FL
  • NPI 1982171419
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1023772738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 W DESOTO ST STE 5E",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112110",
            "telephone_number": "352-396-1247",
            "fax_number": "352-394-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W DESOTO ST STE 5E",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112110",
            "telephone_number": "352-396-1247",
            "fax_number": "352-394-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH GROUP HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "RODERICK",
        "authorized_official_middle_name": "LAROW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-396-1247"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103245100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fabio Echavarria, MD, PA
• Marzena Fabiszak
• Ashley Nicole Fagan, ARNP-C
• Patrick G Fairchild, MD
• Mykeshia Lashay Fairley
• Faith Group Home Inc.
• Briana Falgiano
• Family Life Counseling Center
• Family Life Counseling Center
• Briana Alexis Fannin, DMD

• In Home Supportive Care Agency in Clermont, FL
• Providers in Clermont, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.