| 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 |