Faith Home, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL041732 Issued in NC

Legal business name

FAITH HOME, INC.

Doing business as

Faith Home

Practice address

808 Mystic Dr
Greensboro, NC 27406-5726

Phone

(336) 856-0671

Fax

(336) 856-0671

NPI assigned

Feb 29, 2008

Last updated

Apr 7, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

FAITH HOME, INC.As reported in NPPES

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

Authorized official

Name

Mr. Leon Harlie Sturdivant Sr., DIRECT OWNER (DO)

Title

Owner / Director

Phone

(336) 854-1718

Specialties & licenses 1

Addresses

Other names 1

• Faith Home Doing business as

Part of

Faith Home Inc

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1649449091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 DONLORA DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274076015",
            "telephone_number": "336-854-1718",
            "fax_number": "336-854-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 MYSTIC DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274065726",
            "telephone_number": "336-856-0671",
            "fax_number": "336-856-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH HOME, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAITH HOME, INC.",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "STURDIVANT",
        "authorized_official_first_name": "LEON",
        "authorized_official_middle_name": "HARLIE",
        "authorized_official_title_or_position": "OWNER / DIRECTOR",
        "authorized_official_telephone_number": "336-854-1718",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DIRECT OWNER (DO)"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL041732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Faith Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Faison Medical Care, PLLC
• Alphonza Faison Jr., FNP, RN
• Melissa Faison, LCMHCA
• Stephanie E Faison, LCMHC
• Faith and Works the House of Rebuilding
• Olga Fajardo, MD
• Romulo Andre Salud Fajardo, MD
• Hannah Catherine Falk
• Melynee Morgan Falk
• Falls Therapeutics, PLLC

• Emotionally Disturbed Childrens' Residential Treatment Facility in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.