Provider Demographics
NPI:1003790007
Name:CHRISTIAN FAITH HOME CARE LLC
Entity type:Organization
Organization Name:CHRISTIAN FAITH HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHAZADA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-777-9402
Mailing Address - Street 1:PO BOX 53281
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-3281
Mailing Address - Country:US
Mailing Address - Phone:910-916-4022
Mailing Address - Fax:910-809-2327
Practice Address - Street 1:2423 HIGHWAY 17 S STE 32201623
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-4343
Practice Address - Country:US
Practice Address - Phone:910-916-4022
Practice Address - Fax:910-809-2327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care