Fountain House Group Home, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

FOUNTAIN HOUSE GROUP HOME, INC.

Practice address

403 South Smith
Vinita, OK 74301

Phone

(918) 256-8534

Fax

(918) 256-8513

NPI assigned

Apr 17, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Debi Sufficool

Title

Director

Phone

(918) 256-8534

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669698858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 SOUTH SMITH",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "74301",
            "telephone_number": "918-256-8534",
            "fax_number": "918-256-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 SOUTH SMITH",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "74301",
            "telephone_number": "918-256-8534",
            "fax_number": "918-256-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN HOUSE GROUP HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUFFICOOL",
        "authorized_official_first_name": "DEBI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "918-256-8534",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Farmer, M.S., CCC-SLP
• Michele Feathers-Hefner, MS, LPC
• Kevan Brian Finley, LPC
• Michael F Fisher, MS, LADC/MH
• Kimberly Dawn Folks, RPH
• Trudy Lynn Frost, ARNP
• Jill Christine Galloway
• Vickie Ranay Gardner, LPN
• Tamatha Sue Garner, RN
• Dakota Garrett

• Developmentally Disabled Services Day Training Agency in Vinita, OK
• Providers in Vinita, OK by specialty
• Developmentally Disabled Services Day Training Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.