# FOUNTAIN OF PEACE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FOUNTAIN OF PEACE LLC
- **Other names:** Fountain of Peace Home Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1326753591
- **Legal business name:** FOUNTAIN OF PEACE LLC
- **Authorized official:** YANICK MICHELLE CAMILLE (ADMINISTRATOR)
- **Authorized official phone:** (813) 401-0074

## Contact information

- **Practice address:** 3060 E COLLEGE AVE \# 1009, RUSKIN, FL 33570-5220
- **Practice address phone:** (813) 401-0074
- **Mailing address:** 875 CALICO SCALLOP ST, RUSKIN, FL 33570-8099
- **Mailing address phone:** (813) 401-0074

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/20/2023
- **Last updated:** 01/28/2023