Organization
YOUTHFUL AGING HEALTHCARE SERVICES LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEEMASHEKA JONES (ADMINISTRATOR)
(850) 815-0660
Entity
Organization
Contact information
Practice address
2307 MONDAY RD, TALLAHASSEE, FL 32301-6115
(850) 815-0660
Mailing address
2307 MONDAY RD, TALLAHASSEE, FL 32301-6115
(850) 815-0660
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5182304
FL
174200000X
Meals Provider
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
FL
251E00000X
Home Health Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
311ZA0620X
Adult Care Home Facility
—
—
332U00000X
Home Delivered Meals
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
04/29/2018
Last updated
04/29/2018
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