Provider Demographics
NPI:1871098871
Name:FAITHFULNESSCARELLC
Entity type:Organization
Organization Name:FAITHFULNESSCARELLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HHA
Authorized Official - Prefix:
Authorized Official - First Name:ALECIA
Authorized Official - Middle Name:MANDELA
Authorized Official - Last Name:MALLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-356-5453
Mailing Address - Street 1:835 NW 168TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5326
Mailing Address - Country:US
Mailing Address - Phone:786-356-5453
Mailing Address - Fax:
Practice Address - Street 1:835 NW 168TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-5326
Practice Address - Country:US
Practice Address - Phone:786-356-5453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty