Organization
FOUNTAIN HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH ZIMMERMAN (PRESIDENT & CEO)
(212) 582-0340
Entity
Organization
Contact information
Practice address
425 W 47TH ST, NEW YORK, NY 10036-2304
(212) 582-0340
(212) 957-1424
Mailing address
425 W 47TH ST, NEW YORK, NY 10036-2304
(212) 582-0340
(212) 957-1424
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
01303502
NY
Other
Enumeration date
11/03/2006
Last updated
08/27/2024
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