FAMILY FAITH RESIDENTIAL CARE (NPI# 1083929780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083929780 |
| Entity Type | Organization |
| Organization Name | FAMILY FAITH RESIDENTIAL CARE |
| Practice Address |
7104 Cloverglen Dr Dallas TX 75249-1433 |
| Mailing Address |
821 Quail Run Ln Lancaster TX 75146-2844 |
| Practice Telephone | 9725235043 |
| Mailing Telephone | 9725235043 |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2010-08-18 |
| Authorized Official Name | LATONIA JENNINGS (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 9725235043 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
001009005 | TX | Nursing & Custodial Care Facilities |
| Street Address |
7104 CLOVERGLEN DR |
| City | DALLAS |
| State | TX |
| Zip Code | 75249-1433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184857666 | Latonia Rochelle Jennings | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7104 Cloverglen Dr, Dallas, TX 75249-1433 | 2009-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376192823 | Jackie D Henderson | Residential Treatment Facility, Physical Disabilities | 7041 Hedgebrook Dr, Dallas, TX 75249 | 2019-09-07 |
| 1609311497 | Tiffany Burleson | Counselor | 5859 Foxglove Ln, Dallas, TX 75249 | 2017-01-03 |
| 1245613470 | Chaquita Gibson | Social Worker | 5637 Paladium Dr, Dallas, TX 75249 | 2015-07-07 |
| 1336566462 | Patrice Moreland | Physical Therapist | 8441 Romanway Drive, Dallas, TX 75249 | 2014-03-26 |
| 1861693392 | Daybreak Community Services | Home Health | 7153 Pineberry, Dallas, TX 75249 | 2007-05-31 |
| 1518381185 | Wal-mart Stores Texas, LLC | Technician/Technologist | 7075 W Wheatland Rd, Dallas, TX 75249-0000 | 2014-02-18 |
| 1467810911 | Total Dimensions Family Services, LLC | Case Management | 7328 Bayberry Ln, Dallas, TX 75249-1013 | 2016-01-29 |
| 1225499346 | Sylvia Clark | Case Manager/Care Coordinator | 7328 Bayberry Ln, Dallas, TX 75249-1013 | 2016-03-17 |
| 1548635030 | Whitney Wofford | Health Educator | 7450 Bayberry Ln, Dallas, TX 75249-1015 | 2015-12-09 |
| 1477080463 | Lady L Overshown | Counselor | 7430 Elderberry Ln, Dallas, TX 75249-1044 | 2017-05-22 |
| Find all providers in zip 75249 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164995387 | Red Maple Residential Care, LLC | Custodial Care Facility | 7111 Blackwillow Ln, Dallas, TX 75249-1427 | 2019-01-10 |
| 1356716682 | Raquel Long | Custodial Care Facility | 210 W Pembroke Ave, Dallas, TX 75208-6727 | 2015-12-11 |
| 1851711253 | Romelias Caring Hands | Custodial Care Facility | 10415 Channel Dr, Dallas, TX 75229-4920 | 2014-04-24 |
| 1578808432 | Another Chance Youth Ministry | Custodial Care Facility | 1622 S Beckley Ave, Dallas, TX 75224-2004 | 2012-12-04 |
| 1356553838 | Cox Adult Foster Home | Custodial Care Facility | 8717 Blossom Lane, Dallas, TX 75227 | 2007-05-04 |
| 1164646626 | Christian Heights Community Care, Inc | Custodial Care Facility | 4708 Wadsworth Dr, Dallas, TX 75216-7339 | 2007-04-13 |
| 1760538052 | Regina A. Johnson | Custodial Care Facility | 6125 Singing Hills Dr, Dallas, TX 75241-2630 | 2007-01-27 |
| 1831287994 | Secure Haven Adult Day Care, Inc. | Custodial Care Facility | 2837 W Illinois Ave, Dallas, TX 75233-1005 | 2006-10-11 |
| 1508260886 | A Home of Your Own | Custodial Care Facility | 9822 Amberton Pkwy, Dallas, TX 75243-2016 | 2014-10-15 |
| 1578982849 | Sharel Sullivan | Custodial Care Facility | 12248 China Lake Dr, Dallas, TX 75253-3045 | 2014-04-15 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.