| Fountain Health Care, Llc | |
|
5202 Baltimore National Pike Ste 103&104 Baltimore MD 21229-1022 | |
| (443) 529-6015 | |
| Not Available |
| Full Name | Fountain Health Care, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5202 Baltimore National Pike Ste 103&104, Baltimore, Maryland |
| Authorized Official Name and Position | Akinwumi Alao (CEO) |
| Authorized Official Contact | 3012566624 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fountain Health Care, Llc 5202 Baltimore National Pike Suite 103 & 104 Baltimore MD 21229-1022 Ph: (443) 529-6015 | Fountain Health Care, Llc 5202 Baltimore National Pike Ste 103&104 Baltimore MD 21229-1022 Ph: (443) 529-6015 |
| NPI Number | 1023856580 |
|---|---|
| Provider Enumeration Date | 07/18/2024 |
| Last Update Date | 07/23/2024 |
| Certification Date | 07/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023856580 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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