# FAITH INDEPENDENCE 1A INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962174078
- **Authorized official:** LUE-JIMMIE FILLICIA JOHNSON (OWNER)
- **Authorized official phone:** (407) 309-0481

## Contact information

- **Practice address:** 456 CANBY CIR, OCOEE, FL 34761-8903
- **Practice address phone:** (407) 309-0481
- **Practice address fax:** (407) 641-9799
- **Mailing address:** 456 CANBY CIR, OCOEE, FL 34761-8903
- **Mailing address phone:** (407) 309-0481
- **Mailing address fax:** (407) 641-9799

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/28/2021
- **Last updated:** 09/28/2021