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Organization

FAITHFUL FOUNDATIONS THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
REBECCA TROUT MSPC LPC NCC (CLINICAL SUPERVISOR)
(724) 420-2794
Entity
Organization

Contact information

Practice address
203 GLADE ST SE, WISE, VA 24293-5711
(276) 393-4387
Mailing address
203 GLADE ST SE, WISE, VA 24293-5711

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)

Other

Enumeration date
07/10/2025
Last updated
07/10/2025
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