| Fountain Behavioral Services | |
|
100 Main St S Minot ND 58701-3914 | |
| (701) 839-9363 | |
| (855) 955-1279 |
| Full Name | Fountain Behavioral Services |
|---|---|
| Speciality | Behavior Analyst |
| Location | 100 Main St S, Minot, North Dakota |
| Authorized Official Name and Position | Elise Felicio (OWNER) |
| Authorized Official Contact | 7013899363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fountain Behavioral Services 21 Main St S Minot ND 58701-3890 Ph: () - | Fountain Behavioral Services 100 Main St S Minot ND 58701-3914 Ph: (701) 839-9363 |
| NPI Number | 1356052740 |
|---|---|
| Provider Enumeration Date | 12/07/2022 |
| Last Update Date | 12/08/2023 |
| Certification Date | 12/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356052740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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