Organization
FOUNTAIN OF LIFE HEALTHCARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOLULOPE LASAKI (OWNER)
(331) 231-0380
Entity
Organization
Contact information
Practice address
2803 LEKTORICH LN, PLAINFIELD, IL 60586-7214
(331) 231-0380
Mailing address
2803 LEKTORICH LN, PLAINFIELD, IL 60586-7214
(331) 231-0380
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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