Fountain Of Youth Activity Center, Llc

LBN: Fountain Of Youth Activity Center, Llc
Fountain Of Youth Activity Center, Llc is an health care organization with primary practice located at 8801 E 63Rd St Ste 101 , Raytown MO 64133-4865. The organization recently has 2 registered licenses in different health care specialties including Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization, Transportation Services / Non-emergency Medical Transport (VAN). Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization is the primary health care specialty. Fountain Of Youth Activity Center, Llc can be contacted via phone (816) 886-0442, or through Parker, John via phone (816) 503-9865.

Contact Information

Primary practice address
8801 E 63Rd St Ste 101 Raytown MO 64133-4865
Phone: (816) 886-0442
Fax: (816) 503-9408
Website:
Map and Directions
Authorized official contact:
Name: Parker, John
Phone: (816) 503-9865

Health care specialties

SpecialtyCodeLicense #State
Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization 251T00000X
Transportation Services / Non-emergency Medical Transport (VAN) 343900000X

Profile Details

NPI number 1134797715
LBN Legal business name Fountain Of Youth Activity Center, Llc
DBA Doing business as
Authorized official Parker, John
Entity Organization
Organization subpart 1 No
Enumeration date Jun 11th, 2021
Last updated Jun 11th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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