Fountain of Peace LLC

NPI #1326753591 in Ruskin, Florida

Provider Information

NPI Number: 1326753591
Entity Type: Organization
Organization Name: Fountain of Peace LLC
Subpart: Yes (part of a larger organization)
Parent Organization: FOUNTAIN OF PEACE LLC
Primary Specialty: Home Health
Enumeration Date: Jan 20, 2023
Last Updated: Jan 28, 2023

Practice Location

Address: 3060 E COLLEGE AVE # 1009
City: Ruskin
State: Florida
ZIP Code: 33570-5220
Phone: (813) 401-0074

Authorized Official

Name: YANICK MICHELLE CAMILLE
Title: ADMINISTRATOR
Phone: (813) 401-0074

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Home Health	251E00000X	Primary

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