Fountain Villa Residential Care

NPI 1740320548 - Exclusive Provider Organization - 302F00000X

NPI Details
NPI 1740320548
Enumeration Date 02/08/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JOE C JOE
Position OPERATOR
Phone (620) 365-6002
Fax (620) 365-3510
Practice Location
2620 N KENTUCKY ST
IOLA KS, 66749-1940, US
Phone (620) 365-6002
Fax (620) 365-3510
Business Location
2620 N KENTUCKY ST
IOLA KS, 66749-1940, US
Phone (620) 365-6002
Fax (620) 365-3510
Toxanomy
Taxonomy Code 302F00000X
License State Kansas
License Number N001-006
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According to our database, Fountain Villa Residential Care NPI is 1740320548, taxonomy code is 302F00000X and license number is N001-006, license state is located at Kansas. Fountain Villa Residential Care physically located at 2620 N Kentucky St, Iola KS, 66749-1940. NPI Number 1033115704 has the healthcare provider type.

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1740320548 NPI number is provided on an as is basis without warranty of any kind. 1740320548 is maintained by the National Plan & Provider Enumeration System. The contents of Fountain Villa Residential Care are for informational purposes only.