Faithful Home Care, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

FAITHFUL HOME CARE, LLC

Practice address

622 Denton
Benton, AR 72015-3424

Phone

(501) 708-0902

Fax

(501) 794-6309

NPI assigned

Mar 18, 2019

Organization subpart

No

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

Authorized official

Name

Kristi Townsend

Title

Ownser

Phone

(501) 708-0902

Specialties & licenses 3

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1932668142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MILITARY RD STE 2-127",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152908",
            "telephone_number": "501-708-0902",
            "fax_number": "501-794-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 DENTON",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153424",
            "telephone_number": "501-708-0902",
            "fax_number": "501-794-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITHFUL HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-18",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "TOWNSEND",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "OWNSER",
        "authorized_official_telephone_number": "501-708-0902"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230133757",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230136797",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230135732",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.