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General NPI Number Information
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NPI Number | 1104740885
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Entity Type | Organization
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Legal Business Name | FOUNTAIN HEALTH CARE, LLC
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 3235 OLD WASHINGTON RD STE 1&2
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City | WALDORF
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State | MD
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Zip | 20602-3308
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Country | US
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Telephone | 410-529-6015
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Fax |
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Provider Business Mailing Address
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Address Line | 3235 OLD WASHINGTON RD STE 1&2
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City | WALDORF
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State | MD
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Zip | 20602-3308
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Country | US
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Telephone | 410-529-6015
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. AKINWUMI ALAO
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Credential | MSC
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Telephone | 443-529-6015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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