FOUNTAIN OF LIFE BEHAVIORAL HEALTH COUNSELING & WELLNESS CTR. NPI 1033761325

NPI Information

FOUNTAIN OF LIFE BEHAVIORAL HEALTH COUNSELING & WELLNESS CTR. is a substance abuse rehabilitation facility in Baltimore, MD. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. FOUNTAIN OF LIFE BEHAVIORAL HEALTH COUNSELING & WELLNESS CTR. NPI is 1033761325. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Fountain Of Life Behavioral Health Counseling & Wellness Ctr..

The provider's business location address is:

3704 FAIRVIEW AVE
BALTIMORE, MD
ZIP 21216-313
Phone: (443) 558-8933
Fax: (443) 965-9523

The provider's authorized official is Patricia Ann Harriott .
The authorized official title is Ceo/director and has the following contact phone number (443) 558-8933.

The enumeration date for this NPI number is 7/16/2019 and was last updated on 7/31/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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