Fountain Of Life Behavioral Health Counseling & Wellness Ctr.
LBN: Fountain Of Life Behavioral Health Counseling & Wellness Ctr.
Fountain Of Life Behavioral Health Counseling & Wellness Ctr. is an health care organization with primary practice located at 3704 Fairview Ave , Baltimore MD 21216-1313. The organization recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as the primary health care specialty.
Fountain Of Life Behavioral Health Counseling & Wellness Ctr. can be contacted via phone (443) 558-8933, or through Harriott, Patricia Ann via phone (443) 558-8933.
Contact Information
Primary practice address
3704 Fairview Ave
Baltimore MD 21216-1313
Phone: (443) 558-8933
Fax: (443) 965-9523
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Substance Abuse Rehabilitation Facility | 324500000X |
Profile Details
| NPI number | 1033761325 |
|---|---|
| LBN Legal business name | Fountain Of Life Behavioral Health Counseling & Wellness Ctr. |
| DBA Doing business as | Fountain Of Life Behavioral Health Counseling & Wellness Ctr. |
| Authorized official | Harriott, Patricia Ann PHD,LCPC,GPP |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 16th, 2019 |
| Last updated | Jul 31st, 2019 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033761325 | NPPES |
| Maryland | MEDICAID | 07162019328804 |
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