Fountain Of Life Llc

LBN: Fountain Of Life Llc
Fountain Of Life Llc is an health care organization with primary practice located at 450 W Broad St Ste 211 , Falls Church VA 22046-3318. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty. Fountain Of Life Llc can be contacted via phone (571) 277-4919, or through Klewicki, Lisa via phone (571) 277-4919.

Contact Information

Primary practice address
450 W Broad St Ste 211 Falls Church VA 22046-3318
Phone: (571) 277-4919
Fax: (703) 241-1122
Website:
Map and Directions
Authorized official contact:
Name: Klewicki, Lisa PH.D.
Phone: (571) 277-4919

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810002980 Virginia

Profile Details

NPI number 1396286019
LBN Legal business name Fountain Of Life Llc
DBA Doing business as
Authorized official Klewicki, Lisa PH.D.
Entity Organization
Organization subpart 1 No
Enumeration date Mar 14th, 2017
Last updated Mar 14th, 2017 - about 7 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.

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