MEDICARE: EXPRESSIONS OF LOVE CARE II

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YP1600X	Pastoral Counselor
3	171400000X	Health & Wellness Coach
4	3747P1801X	Personal Care Attendant
5	282J00000X	Religious Nonmedical Health Care Institution

General Provider Information

NPI Number	:	1336915172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPRESSIONS OF LOVE CARE II

Provider Business Mailing Address
First Line	:	1820 NW 28TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-4416
Country	:	US
Telephone Number	:	786-252-5086
Fax Number	:

Provider Business Practice Location Address
First Line	:	1820 NW 28TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-4416
Country	:	US
Telephone Number	:	786-252-5086
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. APRIL L YOUNG SR.
Credential	:	D.DIV
Telephone Number	:	786-252-5086

Provider Enumeration Date	:	12/04/2023
Last Update Date	:	12/12/2023

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Directions to “EXPRESSIONS OF LOVE CARE II ” Practice Location

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