Fountain of Peace LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

FOUNTAIN OF PEACE LLC

Doing business as

Fountain of Peace Home Care

Practice address

3060 E College Ave # 1009
Ruskin, FL 33570-5220

Phone

(813) 401-0074

NPI assigned

Jan 20, 2023

Organization subpart

Yes

Parent organization

FOUNTAIN OF PEACE LLCAs reported in NPPES

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

Authorized official

Name

Yanick Michelle Camille

Title

Administrator

Phone

(813) 401-0074

Specialties & licenses 1

Addresses

Other names 1

• Fountain of Peace Home Care Doing business as

Part of

Fountain of Peace LLC

Locations

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674864000000",
    "number": "1326753591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 CALICO SCALLOP ST",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335708099",
            "telephone_number": "813-401-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 E COLLEGE AVE # 1009",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335705220",
            "telephone_number": "813-401-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN OF PEACE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOUNTAIN OF PEACE LLC",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-28",
        "certification_date": "2023-01-28",
        "status": "A",
        "authorized_official_last_name": "CAMILLE",
        "authorized_official_first_name": "YANICK",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-401-0074"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fountain of Peace Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Ruskin, FL
• Providers in Ruskin, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2023; 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.