FOUNTAIN OF LIFE WELLNESS CENTER; NPI #1558672329

Contact Information

FOUNTAIN OF LIFE WELLNESS CENTER

1314 72ND ST E
TACOMA, WA 98404-3343

Phone: 253-380-5263
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Voluntary or Charitable	251V00000X	61	Voluntary Health or Charitable Agency[1]

Indicates primary specialty

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NPI Profile & details for FOUNTAIN OF LIFE WELLNESS CENTER

NPI # 1558672329

LBN Legal business name FOUNTAIN OF LIFE WELLNESS CENTER

Authorized official BRENDA MILEWSKI - (EXECUTIVE DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/27/2010

Last updated 06/27/2010 - About 16 years ago

Identifiers

License #

602786502

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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FOUNTAIN OF LIFE WELLNESS CENTER

Contact Information

Specialty

Voluntary or Charitable

NPI Profile & details for FOUNTAIN OF LIFE WELLNESS CENTER

Reviews for FOUNTAIN OF LIFE WELLNESS CENTER