Organization
A FOUNTAIN OF YOUTH HOME CARE LLC
Active
Organization
A FOUNTAIN OF YOUTH HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANTELLE LEWIS (ADMINISTRATOR)
(813) 820-8328
Entity
Organization
Contact information
Practice address
2229 RICHWOOD PIKE DR, RUSKIN, FL 33570-8003
(813) 820-8328
Mailing address
2229 RICHWOOD PIKE DR, RUSKIN, FL 33570-8003
(813) 820-8328
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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