Organization
FAITH INDEPENDENCE 1A INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUE-JIMMIE FILLICIA JOHNSON (OWNER)
(407) 309-0481
Entity
Organization
Contact information
Practice address
456 CANBY CIR, OCOEE, FL 34761-8903
(407) 309-0481
(407) 641-9799
Mailing address
456 CANBY CIR, OCOEE, FL 34761-8903
(407) 309-0481
(407) 641-9799
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87-2846497
—
FL
Enumeration date
09/28/2021
Last updated
09/28/2021
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