Faithful Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

FAITHFUL HOME CARE LLC

Practice address

2100 18TH Ave Ste 110
Rock Island, IL 61201-3668

Phone

(309) 798-1828

NPI assigned

Jan 19, 2024

Organization subpart

No

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

Authorized official

Name

Mourice Jack

Title

Owner

Phone

(309) 716-4615

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1891556577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 18TH AVE STE 110",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612013668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 18TH AVE STE 110",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612013668",
            "telephone_number": "309-798-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITHFUL HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "JACK",
        "authorized_official_first_name": "MOURICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-716-4615"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.