NPIMap

Organization Active NPI

Forever Young Care Services, Inc.

  • Home Health Agency
  • Gastonia, NC
National Provider Identifier
1316213986
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC4066 Issued in NC
Legal business name
FOREVER YOUNG CARE SERVICES, INC.
Practice address
1006 Union Rd Ste a
Gastonia, NC 28054-5591
Phone
(704) 869-9790
Fax
(704) 869-9791
NPI assigned
Mar 28, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FOREVER YOUNG CARE SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Serbrena Crawford
Title
Owner/Agency Director
Phone
(704) 869-9790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC4066 NC Primary

Addresses

Primary practice location

1006 Union Rd Ste a
Gastonia, NC 28054-5591

Mailing address

1006 Union Rd Ste a
Gastonia, NC 28054-5591
Phone (704) 869-9790

Other identifiers 1

IdentifierTypeStateIssuer
HC4066OtherNCDIVISION OF HEALTH SERVICE REGULATION (DHSR)

National Provider Directory

National Provider Directory
Tax ID family
Forever Young Care Services Inc2 organizations share this tax ID, including this one
Part of
Forever Young Care Services Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1006 Union Rd
Ste A
Gastonia, NC 28054
Phone (704) 869-9790

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1316213986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 UNION RD STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545591",
            "telephone_number": "704-869-9790",
            "fax_number": "704-869-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 UNION RD STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545591",
            "telephone_number": "704-869-9790",
            "fax_number": "704-869-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREVER YOUNG CARE SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOREVER YOUNG CARE SERVICES, INC.",
        "enumeration_date": "2012-03-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "SERBRENA",
        "authorized_official_title_or_position": "OWNER/AGENCY DIRECTOR",
        "authorized_official_telephone_number": "704-869-9790",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC4066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIVISION OF HEALTH SERVICE REGULATION (DHSR)",
            "identifier": "HC4066",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.