Individual
MR. JOSEPH J FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
127 DAISY ST, MONROEVILLE, AL 36460-2609
(678) 532-1589
Mailing address
127 DAISY ST, MONROEVILLE, AL 36460-2609
(678) 532-1589
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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