FAITH SPRINGS ETERNAL (FASE), PLLC (NPI# 1528696796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528696796 |
| Entity Type | Organization |
| Organization Name | FAITH SPRINGS ETERNAL (FASE), PLLC |
| Practice Address |
2537 Gray Goose Loop Fayetteville NC 28306-3550 |
| Mailing Address |
910 Hope Mills Rd Fayetteville NC 28304-4243 |
| Practice Telephone | 6786126699 |
| Mailing Telephone | 9198886397 |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2020-04-01 |
| Authorized Official Name | MS. IMANI NIA JOHNSON (OWNER, CLINICIAN) |
| Authorized Official Telephone | 9198886397 |
| Authorized Official Credential | MSW, LCSW, LCAS- |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1073938254 | 05 |
| Street Address |
2537 GRAY GOOSE LOOP |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28306-3550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013539501 | Lauren Lockhart | Pharmacist | 5106 Nc-87 #100, Fayetteville, NC 28306 | 2020-05-07 |
| 1528687472 | Edutherapy Connection LLC | Occupational Therapist | 3518 Grenedine Dr, Fayetteville, NC 28306 | 2020-04-10 |
| 1245708213 | Catherine H Cox | Speech-Language Pathologist | Southeastern Communication and Swallowing Specialists, 3530 Boone Trail, Fayetteville, NC 28306 | 2018-11-08 |
| 1720446776 | Wal-mart Store East, Lp | Technician/Technologist | 2820 Gillespie St., Fayetteville, NC 28306 | 2016-02-05 |
| 1720460017 | Sridhar Gottipati | Pharmacist | 10072 Southern Ave., Fayetteville, NC 28306 | 2015-06-23 |
| 1942687900 | St Marys Hca of South Carolina | Clinic/Center | 2603 Cumberland Gap Drive, Suite 203, Fayetteville, NC 28306 | 2015-04-29 |
| 1649696204 | Kathryn Dries | Nurse Practitioner | 7496 Rockfish Road, Fayetteville, NC 28306 | 2014-03-06 |
| 1508288218 | Teresa Mcneill | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3608 Pickerel St, Fayetteville, NC 28306 | 2014-01-15 |
| 1740535715 | Harris Teeter, LLC | Pharmacy | 3050 Traemoor Village Dr, Fayetteville, NC 28306 | 2012-07-17 |
| 1184928848 | Hanora Medical Center, Pllc | Internal Medicine | 2620 Owen Dr, Fayetteville, NC 28306 | 2011-01-10 |
| Find all providers in zip 28306 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1538621602 | A New Beginning for Families Inc | Clinic/Center | 500 Lanier Ave W Ste Aoffice7, Fayetteville, GA 30214-7636 | 2019-04-05 |
| 1386920049 | Point Momentum, P.l.l.c. | Clinic/Center | 4257 Gabel Drive, Fayetteville, AR 72703 | 2011-10-26 |
| 1669606448 | Sunrise Specialty Clinic | Clinic/Center | 709 Hay St, Fayetteville, NC 28301-5423 | 2009-05-08 |
| 1073647392 | Professional Family Care Services, Inc. | Clinic/Center | 350 Wagoner Dr, Suite 103, Fayetteville, NC 28303-4678 | 2007-03-16 |
| 1811032022 | S & T Wecare Community Support | Clinic/Center | 401 Offing Dr, Fayetteville, NC 28314-1043 | 2007-02-21 |
| 1063564003 | Unity Home Care, Inc | Clinic/Center | 211 Fairway Dr, Suite, Fayetteville, NC 28305-5571 | 2007-01-18 |
| 1104882547 | Northwest Counseling & Social Work Services, Inc | Clinic/Center | 111 E Davidson St, Fayetteville, AR 72701-3413 | 2006-04-25 |
| 1558978858 | Day By Day: A Center for Health and Healing | Clinic/Center | 215 N East Ave Ste 102, Fayetteville, AR 72701-5296 | 2020-09-30 |
| 1609482439 | Centerstone of Tennesse Inc. | Clinic/Center | 3505 Village Dr, Fayetteville, NC 28304-4513 | 2020-09-17 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28306 |
Please comment or provide details below to improve the information on FAITH SPRINGS ETERNAL (FASE), PLLC.
| 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.