Faith Based Services, LLC

Primary specialty

HomemakerTaxonomy code 376J00000X

Legal business name

FAITH BASED SERVICES, LLC

Practice address

6959 Loris LN
Jacksonville, FL 32222-1790

Phone

(904) 480-2801

NPI assigned

Oct 13, 2021

Organization subpart

No

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

Authorized official

Name

Dedra R Beaufort, CNA 350293

Title

Owner

Phone

(904) 480-2801

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1316609662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7643 GATE PKWY STE 104-994",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563092",
            "telephone_number": "904-658-0719",
            "fax_number": "904-253-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6959 LORIS LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322221790",
            "telephone_number": "904-480-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH BASED SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "BEAUFORT",
        "authorized_official_first_name": "DEDRA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-480-2801",
        "authorized_official_credential": "CNA 350293"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.