Forever Young of the Palm Beaches Adult Day Care, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

FOREVER YOUNG OF THE PALM BEACHES ADULT DAY CARE, LLC

Practice address

4650 Portofino Way
Apt 212 BLDG 22
West Palm Beach, FL 33409-8159

Phone

(561) 255-3029

Fax

(561) 640-8277

NPI assigned

Nov 7, 2014

Last updated

Nov 7, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shonda Jordan Walker, RN

Title

Ceo/Direct Owner

Phone

(561) 255-3029

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415318400000",
    "number": "1528464260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 PORTOFINO WAY",
            "address_2": "APT 212 BLDG 22",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334098159",
            "telephone_number": "561-255-3029",
            "fax_number": "561-640-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 PORTOFINO WAY",
            "address_2": "APT 212 BLDG 22",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334098159",
            "telephone_number": "561-255-3029",
            "fax_number": "561-640-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREVER YOUNG OF THE PALM BEACHES ADULT DAY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-07",
        "last_updated": "2014-11-07",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "SHONDA",
        "authorized_official_middle_name": "JORDAN",
        "authorized_official_title_or_position": "CEO/DIRECT OWNER",
        "authorized_official_telephone_number": "561-255-3029",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Day Care Clinic/Center in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.