Fountain of Love Assisted Living Inc
NPI 1093021859ActiveOrganization· Social Worker, Clinical· Oak Park, MI
Social Worker, Clinical in Oak Park, Michigan, registered in NPPES in August 2010. The authorized official on file is Shanell Clark, Officer.
Overview
| NPI | 1093021859 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 30, 2010 |
| Last updated in NPPES | Nov 15, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
| Assisted Living Facility | 310400000X | AF630309030 | MI |
| Custodial Care Facility, Adult Care Home | 311ZA0620X | — | — |
| Community Based Residential Treatment Facility, Mental Illness | 320800000X | — | — |
| Respite Care | 385H00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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