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General NPI Number Information
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NPI Number | 1689479552
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Entity Type | Organization
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Legal Business Name | FOUNTAIN OF CARE SOLUTIONS IN HOME AND HEALTHCARE LLC
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Dates
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Enumeration Date | 02/15/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 816 14TH LN
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City | PLEASANT GROVE
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State | AL
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Zip | 35127-1428
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Country | US
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Telephone | 205-520-4966
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Fax |
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Provider Business Mailing Address
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Address Line | 816 14TH LN
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City | PLEASANT GROVE
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State | AL
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Zip | 35127-1428
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Country | US
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Telephone | 205-520-4966
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHEWANA MARIA PICKETT
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Credential | LPN, ALA, CDP
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Telephone | 205-520-4966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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