Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fountain of Youth, Inc

Organization Voluntary or Charitable Agency · NPI 1225202179

Fountain of Youth, Inc is a Voluntary or Charitable Agency in Fort Smith, Arkansas. Licensed in Arkansas. Registered with an NPI since 2008.

Licensed in
AR
In the registry since
2008
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2409 S 56th St Ste 121
Fort Smith, AR 72903-3753
Phone: (479) 484-7782
Fax: (479) 484-7951
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Voluntary or Charitable Agency (primary) Taxonomy 251V00000X · Licence 105 (AR)

Record details

NPI number1225202179
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Foutch — Site Director · (479) 484-7782
NPI enumeratedApril 22, 2008
Last updated in NPPESSeptember 5, 2012
Mailing address2409 S 56th St, Suite 121, Fort Smith, AR 72903-3753

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