Organization
FOUNTAIN PARK HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE STEWART (ADMINISTRATOR)
(419) 238-0715
Entity
Organization
Contact information
Practice address
1112 S WASHINGTON ST, VAN WERT, OH 45891-2409
(419) 238-3133
(419) 238-1625
Mailing address
120 W. MAIN ST., SUITE 200, VAN WERT, OH 45891-1704
(419) 238-0715
(419) 238-1625
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
368142
OH
Other
Enumeration date
01/02/2007
Last updated
02/17/2020
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