Fountain of Love Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

FOUNTAIN OF LOVE HOME CARE LLC

Practice address

4371 Lake Prince Dr
Suffolk, VA 23434-6822

Phone

(757) 633-5245

NPI assigned

Jan 27, 2025

Organization subpart

No

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

Authorized official

Name

Tyisha Michelle Baskerville

Title

Ceo

Phone

(757) 633-5245

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1174336937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 LAKE PRINCE DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234346822",
            "telephone_number": "757-633-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4371 LAKE PRINCE DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234346822",
            "telephone_number": "757-633-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN OF LOVE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "BASKERVILLE",
        "authorized_official_first_name": "TYISHA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-633-5245"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey David Forman, MD
• Victoria Fortin, PA
• Tawana Selina Foster-Holland
• Emily Clifford Foster, MS CCC-SLP, CLC
• Tykisha Michelle Foster, CSAC
• Four Seasons Supportive Living
• Fourth Bay Ventures, LLC
• Dana Christina Fowler, RN
• Veronica Butrese Fowler, O.D.
• Bryan Alan Fox, M.D.

• Home Health Agency in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Home Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.