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Organization
FOUNTAIN OF YOUTH COMMUNITY SERVICES LLC
Active
Organization
FOUNTAIN OF YOUTH COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DREQUEZ LAMBERT (CEO)
(757) 305-6887
Entity
Organization
Contact information
Practice address
3618 CHASE CT, VA BEACH, VA 23462-6805
(757) 305-6887
Mailing address
3793 FIELDSTONE CIR, VIRGINIA BEACH, VA 23453-4713
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Enumeration date
06/06/2023
Last updated
06/06/2023
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