Organization
WALK IN FAITH, PHC, LLC
Active
Other names
WALK IN FAITH, PHC
Organization subpart
No
Provider details
NPI number
Authorized official
JOSIE ANN RODRIGUEZ (ADMINISTRATOR)
(956) 241-1503
Entity
Organization
Contact information
Practice address
111 GIL DR, SAN BENITO, TX 78586-4109
(956) 626-1422
(844) 315-7635
Mailing address
111 GIL DR, SAN BENITO, TX 78586-4109
(956) 626-1422
(844) 315-7635
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0802517983
—
TX
Enumeration date
09/22/2016
Last updated
06/29/2021
Update your record
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