Fountain Therapeutic and Supportive Services LLC
Fountain Therapeutic and Supportive Services LLC provides Clinical Social Worker services in Jacksonville, North Carolina. Licensed in District of Columbia. Registered with an NPI since 2010.
- Licensed in
- DC
- In the registry since
- 2010
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
108 Cardiff Ct # CYJacksonville, NC 28546-7864 Not confirmed with CMS for 11 years — call before visiting
Phone: (301) 437-9666
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinical Social Worker (primary) | Taxonomy 1041C0700X · Licence LC50078852 (DC) |
|---|
Record details
| NPI number | 1285959312 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Janny Jinor — Manager · (301) 437-9666 |
| Other names | Miralife Health Services |
| NPI enumerated | March 31, 2010 |
| Last updated in NPPES | February 11, 2015 |
| Mailing address | 108 Cardiff Ct, Jacksonville, NC 28546-7864 |
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