Fountain of Youth Community Services LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

FOUNTAIN OF YOUTH COMMUNITY SERVICES LLC

Practice address

3618 Chase CT
VA Beach, VA 23462-6805

Phone

(757) 305-6887

NPI assigned

Jun 6, 2023

Last updated

Jun 6, 2023By 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

Mr. Drequez Lambert

Title

Ceo

Phone

(757) 305-6887

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1619661238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3793 FIELDSTONE CIR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234534713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3618 CHASE CT",
            "city": "VA BEACH",
            "state": "VA",
            "postal_code": "234626805",
            "telephone_number": "757-305-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN OF YOUTH COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "LAMBERT",
        "authorized_official_first_name": "DREQUEZ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-305-6887",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.