| NPI | 1417137225 |
|---|---|
| Doing Business As | FOUNTAIN HOUSE |
| Entity Type | Organization |
| Authorized Contact | NATALIE TILTINS Owner/Operator 850-722-0084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: FL AL5222) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2007-11-08 |