A Faithful Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

306004810 Issued in CA

Legal business name

A FAITHFUL HOME LLC

Practice address

26642 Salamanca Dr
Mission Viejo, CA 92691-4923

Phone

(949) 382-2818

Fax

(949) 382-2818

NPI assigned

Jun 24, 2016

Last updated

Jun 24, 2016By 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

Ms. Theresa Serapio Kholoma

Title

Administrator/Licensee

Phone

(714) 300-8055

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1528419207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26642 SALAMANCA DR",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926914923",
            "telephone_number": "949-382-2818",
            "fax_number": "949-382-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26642 SALAMANCA DR",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926914923",
            "telephone_number": "949-382-2818",
            "fax_number": "949-382-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A FAITHFUL HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-24",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "KHOLOMA",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "SERAPIO",
        "authorized_official_title_or_position": "ADMINISTRATOR/LICENSEE",
        "authorized_official_telephone_number": "714-300-8055",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "306004810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; 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.