Organization
FOUNTAIN COMMUNITY HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN KOFI KPONYOH M.D,MBA (CEO)
(502) 542-0964
Entity
Organization
Contact information
Practice address
1232 PARIS PIKE, GEORGETOWN, KY 40324-9701
(502) 542-0964
(502) 868-9152
Mailing address
111 FAWN RUN DR, GEORGETOWN, KY 40324-8402
(502) 542-0964
(502) 868-9152
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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