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FOREVER YOUNG GROUP CARE NPI 1861530073


NPI Information

NPI: 1861530073
Provider Name: FOREVER YOUNG GROUP CARE
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
6121 HILCO DR
FAYETTEVILLE, NC
ZIP 28314
Phone: (910) 527-0258
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FOREVER YOUNG GROUP CARE is a residential treatment facility, intellectual and/or developmental disabilities in Fayetteville, NC. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. FOREVER YOUNG GROUP CARE NPI is 1861530073. The provider is registered as an organization entity type.

The provider's business location address is:

6121 HILCO DR
FAYETTEVILLE, NC
ZIP 28314-024
Phone: (910) 527-0258
Fax: (910) 864-2548

The provider's authorized official is Jerry Lorenzo Flood .
The authorized official title is Director and has the following contact phone number (910) 527-0258.

The enumeration date for this NPI number is 2/1/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesMHL026562NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
16604010MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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