Organization
FOUNTAIN INN HEALTHCARE, LLC
Active
Other names
Fountain Inn Post Acute
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
501 GULLIVER ST, FOUNTAIN INN, SC 29644-2105
(864) 862-2554
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/05/2022
Last updated
08/22/2024
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