| NPI | 1346864147 |
|---|---|
| Doing Business As | FOUNTAIN HOME |
| Entity Type | Organization |
| Authorized Contact | KAYLA C SOL CEO 480-232-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2020-06-08 |