Organization
LIFE FOUNTAIN FMS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILMAR DELGADO (CEO)
(651) 271-4092
Entity
Organization
Contact information
Practice address
418 COUNTY ROAD D E, SAINT PAUL, MN 55117-1218
(651) 344-6220
(651) 340-7958
Mailing address
418 COUNTY ROAD D E, SAINT PAUL, MN 55117-1218
(651) 344-6220
(651) 340-7958
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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