NPI | 1033761325 |
---|---|
Former Legal Business Name | FOUNTAIN OF LIFE BEHAVIORAL HEALTH COUNSELING & WELLNESS CTR. |
Entity Type | Organization |
Authorized Contact | PATRICIA ANN HARRIOTT CEO/Director 443-558-8933 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Enumeration Date | 2019-07-16 |
Last Update Date | 2019-07-31 |