MEDICARE: YOUNG AT HEART ELDERLY SITTING SERVICE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1376257238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUNG AT HEART ELDERLY SITTING SERVICE

Provider Business Mailing Address
First Line	:	2312 BROCK AVE
Second Line	:
City	:	WINTERVILLE
State	:	NC
Zip	:	28590-8892
Country	:	US
Telephone Number	:	252-367-9669
Fax Number	:

Provider Business Practice Location Address
First Line	:	3108 BRIARCLIFF DR
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-4904
Country	:	US
Telephone Number	:	252-320-9553
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	KIANNA MURCHISON
Credential	:
Telephone Number	:	252-367-9669

Provider Enumeration Date	:	01/05/2023
Last Update Date	:	01/06/2023

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