# FOUNTAIN OF LIFE HEALING HOME HEALTH LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fountain of Life Home Health, LP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467556654
- **Authorized official:** MR. GARY BRYAN CRANFORD (ADMINISTRATOR/OWNER)
- **Authorized official phone:** (956) 720-4139

## Contact information

- **Practice address:** 21779 HINOJOSA RD, EDINBURG, TX 78541-5065
- **Practice address phone:** (956) 720-4139
- **Practice address fax:** (956) 720-4167
- **Mailing address:** 5111 N 10TH ST \# 269, MCALLEN, TX 78504-2835
- **Mailing address phone:** (956) 720-4139
- **Mailing address fax:** (956) 720-4167

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 010933 | TX | Yes |

## Other

- **Enumeration date:** 09/11/2006
- **Last updated:** 05/06/2015