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General NPI Number Information
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NPI Number | 1326397415
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Entity Type | Organization
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Legal Business Name | FOREVER YOUNG HOME CARE AGENCY INC
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 1390 INDUSTRIAL BLVD UNIT 4
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City | SOUTHAMPTON
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State | PA
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Zip | 18966-4034
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Country | US
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Telephone | 267-684-6018
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Fax | 267-684-6306
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Provider Business Mailing Address
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Address Line | 1390 INDUSTRIAL BLVD UNIT 4
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City | SOUTHAMPTON
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State | PA
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Zip | 18966-4034
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Country | US
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Telephone | 267-288-5496
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Fax | 267-684-6306
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Authorized Official
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Title or Position | PRESIDENT
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Name | JANE GORBERG
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Credential |
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Telephone | 267-288-5496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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