NPI 1740320548

Fountain Villa Residential Care

Organisation Exclusive Provider Organization Iola, KS

Practice location

Address: 2620 N Kentucky St, Iola, KS 66749-1940
Phone: (620) 365-6002
Fax: (620) 365-3510

Authorised official

Name: Joe C Monsour
Title: Operator
Phone: (620) 365-6002

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence N001-006 (KS)

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Registry record

NPI: 1740320548
Entity type: Organization
NPI issued: 8 Feb 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.