Faith Springs Eternal (Fase), Pllc

LBN: Faith Springs Eternal (Fase), Pllc
Faith Springs Eternal (Fase), Pllc is an health care organization with primary practice located at 910 Hope Mills Rd , Fayetteville NC 28304-4243. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Faith Springs Eternal (Fase), Pllc can be contacted via phone (919) 888-6397, or through Johnson, Imani Nia via phone (678) 612-6699.

Contact Information

Primary practice address
910 Hope Mills Rd Fayetteville NC 28304-4243
Phone: (919) 888-6397
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Imani Nia
Phone: (678) 612-6699

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1528696796
LBN Legal business name Faith Springs Eternal (Fase), Pllc
DBA Doing business as
Authorized official Johnson, Imani Nia
Entity Organization
Organization subpart 1 No
Enumeration date Apr 1st, 2020
Last updated Jul 1st, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528696796 NPPES
North Carolina MEDICAID 1073938254

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