Provider Demographics
NPI:1184393332
Name:FAITH ALLIANCE LLC
Entity type:Organization
Organization Name:FAITH ALLIANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BRANCH MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-922-0975
Mailing Address - Street 1:2211 RIMLAND DR STE 405
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-5699
Mailing Address - Country:US
Mailing Address - Phone:360-922-0975
Mailing Address - Fax:360-325-7035
Practice Address - Street 1:2211 RIMLAND DR STE 405
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-5699
Practice Address - Country:US
Practice Address - Phone:360-922-0975
Practice Address - Fax:360-325-7035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health