OrganizationActive
Fountain of Youth, Inc
NPI 1225202179 · Voluntary or Charitable Agency · Fort Smith, AR
Fountain of Youth, Inc is a Voluntary or Charitable Agency organization in Fort Smith, AR (NPI 1225202179).
Provider details
- NPI number
- 1225202179
- Entity type
- Organization
- Primary specialty
- Voluntary or Charitable AgencyAgencies
- Organization subpart
- No
- Authorized official
- Michelle Foutch, Site Director(479) 484-7782
- License
- 105 (AR)
Specialties & taxonomies
Agencies
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2409 S 56th St
Suite 121
Fort Smith, AR 72903-3753
Phone: (479) 484-7782
Fax: (479) 484-7951
Street-level locationGet directions
Mailing address
2409 S 56th St
Fort Smith, AR 72903-3753
Registry dates
- Enumerated
- 2008-04-22
- Last updated
- 2012-09-05
Frequently asked questions
- What is Fountain of Youth, Inc's NPI number?
- Fountain of Youth, Inc's National Provider Identifier (NPI) is 1225202179, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fountain of Youth, Inc?
- Fountain of Youth, Inc is classified in the NPPES registry as Voluntary or Charitable Agency (Agencies).
- Where is Fountain of Youth, Inc located?
- Fountain of Youth, Inc's practice location on file with NPPES is 2409 S 56th St, Fort Smith, AR 72903-3753.
- What is Fountain of Youth, Inc's phone number?
- The practice phone number listed in the NPPES registry for Fountain of Youth, Inc is (479) 484-7782.
- Who is the authorized official for Fountain of Youth, Inc?
- The authorized official listed on Fountain of Youth, Inc's NPPES record is Michelle Foutch, Site Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fountain of Youth, Inc's NPI active?
- Yes — Fountain of Youth, Inc's NPI (1225202179) is active in the NPPES registry as of the last update on 2012-09-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.