Organization · Type 2 NPI

Fountain of Youth, LLC

Clinic/Center · Terre Haute, IN

NPI number 1316205115 Active

Practice location

8810 Wabash Ave
Terre Haute, IN 47803-3908

Call (812) 239-4090 Map

Specialties and licenses

TaxonomyCodeLicense
Clinic/Center Primary 261Q00000X71002624A (IN)

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Other clinic/center providers in Terre Haute

See all in Terre Haute →

About NPI 1316205115

Fountain of Youth, LLC's National Provider Identifier is 1316205115, issued on Apr 30, 2012. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Terre Haute, IN. The record was last updated on Apr 30, 2012.