Organization · Type 2 NPI
Fountain of Youth LLC Residential Care
Adult Care Home Facility · Mount Olive, NC
NPI number
1306608195
Active
Practice location
1116 S Church St
Mount Olive, NC 28365-2504
Mailing address
810 Kilarney Dr
Fredericksburg, VA 22407-6558
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | None listed |
| Adult Care Home Facility Primary | 311ZA0620X | None listed |
| Private Vehicle | 347C00000X | None listed |
Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Other adult care home facility providers in Mount Olive
About NPI 1306608195
Fountain of Youth LLC Residential Care's National Provider Identifier is 1306608195, issued on Jan 26, 2024. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Mount Olive, NC. The record was last updated on Jan 13, 2025.