institution
Fountain Of Youth, Inc
Voluntary or Charitable Agency in Fort Smith, Arkansas
NPI 1225202179

Fountain Of Youth, Inc is a Voluntary or Charitable Agency based in Fort Smith, AR. Fountain Of Youth, Inc practices in Fort Smith, AR. The NPI Number for Fountain Of Youth, Inc is 1225202179 and holds a License No. 105 (Arkansas).

The current practice location address for Fountain Of Youth, Inc is 2409 S 56Th St, Fort Smith, AR and can be reached out via phone at 479-484-7782 and via fax at 479-484-7951.

Location: 2409 S 56Th St, Fort Smith, AR, 72903-3753
institution
Provider Profile Details
NPI Number
1225202179
Provider Name
Fountain Of Youth, Inc
Credential
Provider Entity Type
Organization
Address
2409 S 56Th St, Fort Smith, AR, 72903-3753
Phone Number
479-484-7782
Fax Number
479-484-7951
Provider Enumeration Date
04/22/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
165464755 05 AR
institution
Provider Business Practice Location Address Details
Address
2409 S 56Th St
City
State
Zip
72903-3753
Phone Number
479-484-7782
Fax Number
479-484-7951
person
Provider Business Mailing Address Details
Address
2409 S 56Th St
City
State
Zip
72903-3753
Phone Number
479-484-7782
Fax Number
479-484-7951
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Voluntary or Charitable
Speciality
-
Taxonomy
License No.
105 (Arkansas)
Definition
Definition to come...
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