NPIMap

Organization Active NPI

Young Hearts Extended Assisted Living Facility, LLC

  • Assisted Living Facility
  • Lawtey, FL
National Provider Identifier
1497219133
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
YOUNG HEARTS EXTENDED ASSISTED LIVING FACILITY, LLC
Practice address
1410 NE 219TH St
Lawtey, FL 32058-4387
Phone
(904) 769-1122
NPI assigned
Jan 28, 2019
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Ms. Nikita Latrice Jenkins, RN, RN-BC
Title
RN/Administrator
Phone
(904) 769-1122

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 3

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

National Provider Directory

National Provider Directory
Tax ID family
Young Hearts Extended Assisted Living Facility LLC (4 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1410 NE 219TH St
Lawtey, FL 32058-4387

Mailing address

1410 NE 219TH St
Lawtey, FL 32058-4387
Phone (904) 769-1122

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 28, 2019.

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548633600000",
    "number": "1497219133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 NE 219TH ST",
            "city": "LAWTEY",
            "state": "FL",
            "postal_code": "320584387",
            "telephone_number": "904-769-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 NE 219TH ST",
            "city": "LAWTEY",
            "state": "FL",
            "postal_code": "320584387",
            "telephone_number": "904-769-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG HEARTS EXTENDED ASSISTED LIVING FACILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-28",
        "last_updated": "2019-01-28",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "NIKITA",
        "authorized_official_middle_name": "LATRICE",
        "authorized_official_title_or_position": "RN/ADMINISTRATOR",
        "authorized_official_telephone_number": "904-769-1122",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, RN-BC"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawtey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.