NPIMap

Organization Active NPI

Forever Young Group Care, LLC

  • Community/Behavioral Health Agency
  • Wilson, NC
National Provider Identifier
1427245927
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FOREVER YOUNG GROUP CARE, LLC
Practice address
207 Harrison Dr N
Wilson, NC 27893-1791
Phone
(252) 293-9815
Fax
(252) 293-9816
NPI assigned
Sep 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Jerry Flood, EXE
Title
Executive Director
Phone
(252) 293-9815

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

207 Harrison Dr N
Wilson, NC 27893-1791

Mailing address

1133 Chestnut Wood Dr
Fayetteville, NC 28314-1890
Phone (910) 527-0258

National Provider Directory

National Provider Directory
Tax ID family
Forever Young Group Care4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

207 Harrison Dr N
Wilson, NC 27893
Phone (252) 293-9815

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1427245927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 CHESTNUT WOOD DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141890",
            "telephone_number": "910-527-0258",
            "fax_number": "910-864-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HARRISON DR N",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278931791",
            "telephone_number": "252-293-9815",
            "fax_number": "252-293-9816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREVER YOUNG GROUP CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "FLOOD",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "252-293-9815",
        "authorized_official_credential": "EXE"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.