Organization
FOUNTAIN HOUSE GROUP HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBI SUFFICOOL (DIRECTOR)
(918) 256-8534
Entity
Organization
Contact information
Practice address
403 SOUTH SMITH, VINITA, OK 74301
(918) 256-8534
(918) 256-8513
Mailing address
403 SOUTH SMITH, VINITA, OK 74301
(918) 256-8534
(918) 256-8513
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
04/17/2007
Last updated
08/22/2020
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