Provider Demographics
NPI:1689479552
Name:FOUNTAIN OF CARE SOLUTIONS IN HOME AND HEALTHCARE LLC
Entity type:Organization
Organization Name:FOUNTAIN OF CARE SOLUTIONS IN HOME AND HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHEWANA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:PICKETT
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, ALA, CDP
Authorized Official - Phone:205-520-4966
Mailing Address - Street 1:816 14TH LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:AL
Mailing Address - Zip Code:35127-1428
Mailing Address - Country:US
Mailing Address - Phone:205-520-4966
Mailing Address - Fax:
Practice Address - Street 1:816 14TH LN
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:AL
Practice Address - Zip Code:35127-1428
Practice Address - Country:US
Practice Address - Phone:205-520-4966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care