| NPI | 1255636841 |
|---|---|
| Doing Business As | FOUNTAIN VALLEY HOME |
| Entity Type | Organization |
| Authorized Contact | MARK R FAWCETT Treasurer 781-699-9000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2012-09-26 |