Fountain Gate Life & Wellness, Inc.

NPI 1780966051 - Social Worker - 1041C0700X

NPI Details
NPI 1780966051
Enumeration Date 09/13/2011
Last Updated 11/03/2015
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name CRAIG CRAIG
Position EXECUTIVE DIRECTOR
Phone (770) 218-9005
Fax (770) 485-8481
Practice Location
2985 CHEROKEE ST NW
KENNESAW GA, 30144-2863, US
Phone (770) 218-9005
Fax (770) 485-8481
Business Location
2985 CHEROKEE ST NW
KENNESAW GA, 30144-2863, US
Phone (770) 218-9005
Fax (770) 485-8481
Toxanomy
Taxonomy Code 1041C0700X
License State
License Number
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According to our database, Fountain Gate Life & Wellness, Inc. NPI is 1780966051, taxonomy code is 1041C0700X Fountain Gate Life & Wellness, Inc. physically located at 2985 Cherokee St Nw, Kennesaw GA, 30144-2863. NPI Number 1033115704 has the healthcare provider type.

1780966051 NPI number is provided on an as is basis without warranty of any kind. 1780966051 is maintained by the National Plan & Provider Enumeration System. The contents of Fountain Gate Life & Wellness, Inc. are for informational purposes only.