# FAITH HOME, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FAITH HOME, INC.
- **Other names:** Faith Home
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1649449091
- **Legal business name:** FAITH HOME, INC.
- **Authorized official:** MR. LEON HARLIE STURDIVANT SR. DIRECT OWNER (DO) (OWNER / DIRECTOR)
- **Authorized official phone:** (336) 854-1718

## Contact information

- **Practice address:** 808 MYSTIC DR, GREENSBORO, NC 27406-5726
- **Practice address phone:** (336) 856-0671
- **Practice address fax:** (336) 856-0671
- **Mailing address:** 2501 DONLORA DR, GREENSBORO, NC 27407-6015
- **Mailing address phone:** (336) 854-1718
- **Mailing address fax:** (336) 854-1718

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL041732 | NC | Yes |

## Other

- **Enumeration date:** 02/29/2008
- **Last updated:** 04/07/2008