Provider Demographics
NPI:1679330278
Name:FAITH OF A MUSTARD SEED CARE SERVICES L L C
Entity type:Organization
Organization Name:FAITH OF A MUSTARD SEED CARE SERVICES L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-907-4850
Mailing Address - Street 1:3104 SUNNYBROOK CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32254-3176
Mailing Address - Country:US
Mailing Address - Phone:904-907-4850
Mailing Address - Fax:
Practice Address - Street 1:3104 SUNNYBROOK CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32254-3176
Practice Address - Country:US
Practice Address - Phone:904-907-4850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health