Organization
FOUNTAIN OF LIFE COMMUNITY DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRON PARRISH (CEO)
(954) 391-6080
Entity
Organization
Contact information
Practice address
6741 PEMBROKE RD, PEMBROKE PINES, FL 33023-2143
(954) 391-6080
(954) 391-6081
Mailing address
6741 PEMBROKE RD, PEMBROKE PINES, FL 33023-2143
(954) 391-6080
(954) 391-6081
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/02/2011
Last updated
12/02/2011
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