Fountain of Life Community Development Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FOUNTAIN OF LIFE COMMUNITY DEVELOPMENT CENTER

Practice address

6741 Pembroke Rd
Pembroke Pines, FL 33023-2143

Phone

(954) 391-6080

Fax

(954) 391-6081

NPI assigned

Dec 2, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sherron Parrish

Title

Ceo

Phone

(954) 391-6080

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322784000000",
    "number": "1104194356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6741 PEMBROKE RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330232143",
            "telephone_number": "954-391-6080",
            "fax_number": "954-391-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6741 PEMBROKE RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330232143",
            "telephone_number": "954-391-6080",
            "fax_number": "954-391-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN OF LIFE COMMUNITY DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-02",
        "status": "A",
        "authorized_official_last_name": "PARRISH",
        "authorized_official_first_name": "SHERRON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-391-6080"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Warren Forstmann
• Carlos Forte, PTA, CKTP
• Takese Foster
• Fostering Our Angels Inc.
• Fountain Imaging of Pembroke Pines,LLC
• Four Leaf Home Care LLC
• Four Star Corporate Catering
• Four Walls Studio LLC
• Fourth Trimester Care Group LLC
• Jennifer Anne Fowler, APRN, FNP-C

• Community/Behavioral Health Agency in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.