| Fountain Of Youth Llc Residential Care | |
|
1116 S Church St Mount Olive NC 28365-2504 | |
| (919) 299-4539 | |
| Not Available |
| Full Name | Fountain Of Youth Llc Residential Care |
|---|---|
| Speciality | Custodial Care Facility - Adult Care Home |
| Location | 1116 S Church St, Mount Olive, North Carolina |
| Authorized Official Name and Position | Sadio Sykes (ADMINISTER) |
| Authorized Official Contact | 5714844472 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fountain Of Youth Llc Residential Care 810 Kilarney Dr Fredericksburg VA 22407-6558 Ph: (571) 484-4472 | Fountain Of Youth Llc Residential Care 1116 S Church St Mount Olive NC 28365-2504 Ph: (919) 299-4539 |
| NPI Number | 1306608195 |
|---|---|
| Provider Enumeration Date | 01/26/2024 |
| Last Update Date | 01/13/2025 |
| Certification Date | 01/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306608195 | NPI | - | NPPES |
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