Active NPI
Youthful Aging Healthcare Services LLC.
- Licensed Practical Nurse
- Tallahassee, FL
National Provider Identifier
1760970347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN5182304
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Keemasheka Jones
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 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 DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Licensed Practical Nurse
- Tallahassee, FL
- NPI 1033631023
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.