Provider Demographics
NPI:1346516077
Name:FOREVER YOUNG HOME CARE
Entity Type:Organization
Organization Name:FOREVER YOUNG HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:S
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-740-9450
Mailing Address - Street 1:2309 W CONE BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-4044
Mailing Address - Country:US
Mailing Address - Phone:336-740-9450
Mailing Address - Fax:336-740-9455
Practice Address - Street 1:2309 W CONE BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4044
Practice Address - Country:US
Practice Address - Phone:336-740-9450
Practice Address - Fax:336-740-9455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4229253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care