| NPI | 1841555620 |
|---|---|
| Other Name | FOUNTAIN OF LIFE |
| Entity Type | Organization |
| Authorized Contact | THELMA JEAN CONNER Administrator 773-434-6370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 311500000X Alzheimer Center (Dementia Center) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2022-08-08 |