| Fountain Home | |
|
5948 E Fountain Cir Mesa AZ 85205-5513 | |
| (480) 232-8600 | |
| (480) 444-1452 |
| Full Name | Fountain Home |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 5948 E Fountain Cir, Mesa, Arizona |
| Authorized Official Name and Position | Kayla C Sol (CEO) |
| Authorized Official Contact | 4802328600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fountain Home 501 S 48th St Ste 110 Tempe AZ 85281-2313 Ph: (480) 232-8600 | Fountain Home 5948 E Fountain Cir Mesa AZ 85205-5513 Ph: (480) 232-8600 |
| NPI Number | 1346864147 |
|---|---|
| Provider Enumeration Date | 06/08/2020 |
| Last Update Date | 06/08/2020 |
| Certification Date | 06/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346864147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Secondary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | () | Primary |
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