Young at Heart Social Club LLC

Primary specialty

Adult CompanionTaxonomy code 372600000X

Legal business name

YOUNG AT HEART SOCIAL CLUB LLC

Practice address

3005 Olive Ave S
Lehigh Acres, FL 33976-3961

Phone

(239) 810-5587

NPI assigned

Sep 11, 2026

Organization subpart

No

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

Authorized official

Name

Mrs. Valencia Cromwell

Title

Authorized Member

Phone

(239) 810-5587

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1789084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789084800000",
    "number": "1821908773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 OLIVE AVE S",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339763961",
            "telephone_number": "239-810-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 OLIVE AVE S",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339763961",
            "telephone_number": "239-810-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG AT HEART SOCIAL CLUB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-11",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A",
        "authorized_official_last_name": "CROMWELL",
        "authorized_official_first_name": "VALENCIA",
        "authorized_official_title_or_position": "AUTHORIZED MEMBER",
        "authorized_official_telephone_number": "239-810-5587",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Adult Companion",
            "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 Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.