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Organization
FAITHFUL NUBIAN SERVICES, LLC
Active
Organization
FAITHFUL NUBIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SURENA GLOVER (OWNER)
(757) 419-3941
Entity
Organization
Contact information
Practice address
410 HUSTINGS LN, UNIT E, NEWPORT NEWS, VA 23608-2807
(757) 491-3941
(757) 325-8283
Mailing address
410 HUSTINGS LN, UNIT E, NEWPORT NEWS, VA 23608-2807
(757) 491-3941
(757) 325-8283
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
Other
Enumeration date
05/16/2016
Last updated
05/16/2016
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