Faith Harbor

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

FAITH HARBOR

Practice address

1268 Campbell LN Ste 101
Bowling Green, KY 42104-1034

Phone

(270) 781-4050

Fax

(270) 781-4099

NPI assigned

Oct 19, 2015

Last updated

Oct 19, 2015By 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

Mrs. Angel Lynnette Lee, SCL, IPD

Title

Owner/Executive Director

Phone

(270) 781-4050

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1790156628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "ROCKFIELD",
            "state": "KY",
            "postal_code": "422740151",
            "telephone_number": "270-781-4050",
            "fax_number": "270-781-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 CAMPBELL LN STE 101",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421041034",
            "telephone_number": "270-781-4050",
            "fax_number": "270-781-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH HARBOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "LYNNETTE",
        "authorized_official_title_or_position": "OWNER/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "270-781-4050",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "SCL, IPD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kristian Wendolyn Falcon, DO
• Family Care Clinical Services, PLLC
• Family First Developmental Services
• Family Options, Inc.

• Developmentally Disabled Services Day Training Agency in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Developmentally Disabled Services Day Training Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.