Healthcare Provider Details

I. General information

NPI: 1942668587
Provider Name (Legal Business Name): B. FOREVER YOUNG HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2016
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 FLORIN RD SUITE 7
SACRAMENTO CA
95822-4401
US

IV. Provider business mailing address

2245 FLORIN RD SUITE 7
SACRAMENTO CA
95822-4401
US

V. Phone/Fax

Practice location:
  • Phone: 877-226-5452
  • Fax:
Mailing address:
  • Phone: 877-226-5452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: BRITTANNY NICOLE YOUNG
Title or Position: OWNER
Credential:
Phone: 18772265452