Provider Demographics
NPI:1366758351
Name:FAITH CHRISTIAN FELLOWSHIP
Entity type:Organization
Organization Name:FAITH CHRISTIAN FELLOWSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:PARTRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-668-2310
Mailing Address - Street 1:PO BOX 545
Mailing Address - Street 2:
Mailing Address - City:EAKLY
Mailing Address - State:OK
Mailing Address - Zip Code:73033-0545
Mailing Address - Country:US
Mailing Address - Phone:405-668-2310
Mailing Address - Fax:
Practice Address - Street 1:21113 COUNTY ST 2520
Practice Address - Street 2:
Practice Address - City:HYDRO
Practice Address - State:OK
Practice Address - Zip Code:73048
Practice Address - Country:US
Practice Address - Phone:405-668-2310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAITH CHRISTIAN FELLOWSHIP INTERNATIONAL CHURCH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management