Provider Demographics
NPI:1477891703
Name:YOUNIQUE INNOVATED HEALTHCARE
Entity Type:Organization
Organization Name:YOUNIQUE INNOVATED HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAKEVA
Authorized Official - Middle Name:PANELA
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:352-359-6725
Mailing Address - Street 1:2049 NE 15TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-3978
Mailing Address - Country:US
Mailing Address - Phone:352-359-6725
Mailing Address - Fax:352-336-3725
Practice Address - Street 1:2049 NE 15TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3978
Practice Address - Country:US
Practice Address - Phone:352-359-6725
Practice Address - Fax:352-336-3725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9229522251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health