Organization
THE FOUNTAINS LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BASHIR BARKADLE (DIRECTOR)
(612) 707-5235
Entity
Organization
Contact information
Practice address
12406 ALDER ST NW, COON RAPIDS, MN 55448-4801
(612) 707-5235
Mailing address
12406 ALDER ST NW, COON RAPIDS, MN 55448-4801
(612) 707-5235
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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