Provider Demographics
NPI:1285083659
Name:YOUNG AT HEART ADULT DAYCARE LLC
Entity type:Organization
Organization Name:YOUNG AT HEART ADULT DAYCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CENTER OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-562-9527
Mailing Address - Street 1:3801 N UNIVERSITY DR
Mailing Address - Street 2:SUITE #505
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6332
Mailing Address - Country:US
Mailing Address - Phone:954-748-1151
Mailing Address - Fax:954-414-1213
Practice Address - Street 1:3801 N UNIVERSITY DR
Practice Address - Street 2:SUITE #505
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6332
Practice Address - Country:US
Practice Address - Phone:954-748-1151
Practice Address - Fax:954-414-1213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68942261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care