FOUNTAIN THERAPEUTIC AND SUPPORTIVE SERVICES LLC

JACKSONVILLE, NC
NPI1285959312
Doing Business AsMIRALIFE HEALTH SERVICES
Entity TypeOrganization
Authorized ContactJANNY JINOR
Manager
301-437-9666
Organization Subpart ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: DC  LC50078852)
Enumeration Date2010-03-31
Last Update Date2015-02-11
Business Address
FOUNTAIN THERAPEUTIC AND SUPPORTIVE SERVICES LLC
108 CARDIFF CT # CY
JACKSONVILLE, NC 28546-7864
Phone number: 301-437-9666
Mailing Address
FOUNTAIN THERAPEUTIC AND SUPPORTIVE SERVICES LLC
108 CARDIFF CT
JACKSONVILLE, NC 28546-7864
Phone number: 301-437-9666