Fountain of Youth

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

FOUNTAIN OF YOUTH

Practice address

26 Dumont Ave
Staten Island, NY 10305-1450

Phone

(718) 667-8510

Fax

(718) 667-8884

NPI assigned

May 1, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brent Alexander

Title

President

Phone

(718) 667-8521

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398902400000",
    "number": "1144630963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 DUMONT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051450",
            "telephone_number": "718-667-8510",
            "fax_number": "718-667-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 DUMONT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051450",
            "telephone_number": "718-667-8510",
            "fax_number": "718-667-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN OF YOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-01",
        "last_updated": "2014-05-01",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-667-8521"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barkel Thomas Foster
• Nina Fostik
• Vicky Fotiou
• Foundations Learning & Development LLC
• Foundations Podiatry P.C.
• Fountain Pulmonary P.C
• Four Bridges Social Work Services LCSW PC
• Mary Fourte, MS CCC-SLP
• Andrea Fox, BS PHARM
• Angela Maria Fox, R.N.

• Adult Day Care Clinic/Center in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Adult Day Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.