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FOUNTAIN OF LIFE HEALTHCARE PC.
NPI 1396494878
Clinic/Center - Mental Health (Including Community Mental Health Center) in Lanham, MD

Active since March 22, 2022
7375 EXECUTIVE PL, LANHAM, MD 20706(301) 806-7473(410) 988-2868 Get Directions Write a Review

NPPES record last updated: July 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fountain Of Life Healthcare Pc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOUNTAIN OF LIFE HEALTHCARE PC. (NPI 1396494878) is a healthcare organization registered as a mental health (including community mental health center) in Lanham, Maryland and active in the NPI registry since March 2022. The organization lists Chidi Roovelt Nwachukwu, Provider, as its authorized official.

NPPES Registry Identity

NPI1396494878
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameFOUNTAIN OF LIFE HEALTHCARE PC.
Location Address7375 EXECUTIVE PLLanham, MD 20706-2278
Mailing Address7375 Executive PlLanham, MD 20706-2278 · (301) 806-7473 · Fax (410) 988-2868
Phone(301) 806-7473
Fax(410) 988-2868
Organization SubpartNo
Authorized OfficialChidi Roovelt NwachukwuProvider · (410) 777-5292
Enumeration DateMarch 22, 2022
Last NPPES UpdateJuly 13, 2023
NPPES CertifiedJuly 13, 2023
✔ NPI 1396494878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
7375 EXECUTIVE PL, Lanham, MD 20706
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Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TANESHA ANN JONES
Behavior Technician
7375 EXECUTIVE PL
LANHAM, MD 20706
Prince George's County (202) 207-0720
TANYA TRACY-ANN BROWN
Behavior Technician
7375 EXECUTIVE PL
LANHAM, MD 20706
Prince George's County (301) 970-9678
SYDNEY VICTORIA DABBAH
Behavior Technician
7375 EXECUTIVE PL, SUITE 203
LANHAM, MD 20706
Prince George's County (301) 970-9678
SANIYAH MEIJHAN WILLS
Behavior Technician
7375 EXECUTIVE PL
LANHAM, MD 20706
Prince George's County (202) 207-0720
BEACON HEALTH & WELLNESS SERVICES LLC
Nurse Practitioner (Family)
7375 EXECUTIVE PL
LANHAM, MD 20706
Prince George's County (301) 828-9006
MARITA ATEHAKOH FORMIN NP
Nurse Practitioner (Psychiatric/Mental Health)
7375 EXECUTIVE PL
LANHAM, MD 20706
Prince George's County (202) 940-2022
CHIDI ROOVELT NWACHUKWU CRNP
Nurse Practitioner (Psychiatric/Mental Health)
7375 EXECUTIVE PL
LANHAM, MD 20706
Prince George's County (301) 806-7473
SULIAT OGUNMONA
Behavior Technician
7375 EXECUTIVE PL
LANHAM, MD 20706
Prince George's County (301) 970-9678

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fountain Of Life Healthcare PC.'s NPI number?

The NPI number for Fountain Of Life Healthcare PC. is 1396494878. It was assigned to this organization in the NPPES registry on March 22, 2022.

Where is Fountain Of Life Healthcare PC. located?

Fountain Of Life Healthcare PC. is located at 7375 Executive Pl, Lanham, MD 20706. The listed phone number is (301) 806-7473.

What is Fountain Of Life Healthcare PC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Fountain Of Life Healthcare PC. was last updated on July 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.