Organization Active NPI

Youthful Aging Healthcare Services LLC.

  • Licensed Practical Nurse
  • Tallahassee, FL
National Provider Identifier
1760970347
Registry record updated Apr 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5182304 Issued in FL
Legal business name
YOUTHFUL AGING HEALTHCARE SERVICES LLC.
Practice address
2307 Monday Rd
Tallahassee, FL 32301-6115
Phone
(850) 815-0660
NPI assigned
Apr 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2018

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

Authorized official

Name
Keemasheka JonesNPI 1033631023
Title
Administrator
Phone
(850) 815-0660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193200000X MULTI-SPECIALTY GROUP 164W00000X PN5182304 FL Primary
Meals Provider 174200000X
Developmentally Disabled Services Day Training Agency 251C00000X
Home Health Agency 251E00000X FL
Home Health Agency 251E00000X
Community Based Hospice Care Agency 251G00000X
Nursing Care Agency 251J00000X
In Home Supportive Care Agency 253Z00000X
Assisted Living Facility 310400000X
Assisted Living Facility (Mental Illness) 3104A0625X
Adult Care Home Facility 311ZA0620X
Home Delivered Meals 332U00000X
Non-emergency Medical Transport (VAN) 343900000X
Private Vehicle 347C00000X
Respite Care 385H00000X

Addresses

Primary practice location

2307 Monday Rd
Tallahassee, FL 32301-6115

Mailing address

2307 Monday Rd
Tallahassee, FL 32301-6115
Phone (850) 815-0660

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1524960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524960000000",
    "number": "1760970347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 MONDAY RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323016115",
            "telephone_number": "850-815-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 MONDAY RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323016115",
            "telephone_number": "850-815-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTHFUL AGING HEALTHCARE SERVICES LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-29",
        "last_updated": "2018-04-29",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KEEMASHEKA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "850-815-0660"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5182304",
            "primary": true
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2018; 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.