Young Hearts Extended Assisted Living Facility, LLC

Key facts

NPI: 1497688196
Entity type: Organization (NPI type 2)
Primary specialty: Homemaker 376J00000X
Legal business name: YOUNG HEARTS EXTENDED ASSISTED LIVING FACILITY, LLC
Practice address: 1410 NE 219TH St
Lawtey, FL 32058-4387
Phone: (904) 769-1122
Fax: (206) 844-9037
NPI assigned: Jun 4, 2026
Organization subpart: Yes
Parent organization (as reported): YOUNG HEARTS EXTENDED ASSISTED LIVING FACILITY, LLC

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

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

Tax ID family: Young Hearts Extended Assisted Living Facility LLC (4 organizations share this tax ID)
Part of: Young Hearts Extended Assisted Living Facility LLC

Specialty (taxonomy)	Code	License	State	Primary
Homemaker Group: 193200000X MULTI-SPECIALTY GROUP	376J00000X			Yes

1410 NE 219TH St
Lawtey, FL 32058-4387

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

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2026. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.