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Fountain Of Youth Activity Center, Llc
Non-emergency Medical Transport (VAN) in Raytown, Missouri
NPI 1134797715

Fountain Of Youth Activity Center, Llc is a Non-emergency Medical Transport (VAN) based in Raytown, MO. Fountain Of Youth Activity Center, Llc practices in Raytown, MO. The NPI Number for Fountain Of Youth Activity Center, Llc is 1134797715 and holds a License No. (Missouri).

The current practice location address for Fountain Of Youth Activity Center, Llc is 8801 E 63Rd St Ste 101, Raytown, MO and can be reached out via phone at 816-886-0442 and via fax at 816-503-9408.

Location: 8801 E 63Rd St Ste 101, Raytown, MO, 64133-4865
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1134797715
Provider Name
Fountain Of Youth Activity Center, Llc
Credential
Provider Entity Type
Organization
Address
8801 E 63Rd St Ste 101, Raytown, MO, 64133-4865
Phone Number
816-886-0442
Fax Number
816-503-9408
Provider Enumeration Date
06/11/2021
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
8801 E 63Rd St Ste 101
City
Raytown
State
Missouri
Zip
64133-4865
Phone Number
816-886-0442
Fax Number
816-503-9408
person
Provider Business Mailing Address Details
Address
8801 E 63Rd St Ste 101
City
Raytown
State
Missouri
Zip
64133-4865
Phone Number
816-886-0442
Fax Number
816-503-9408
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization
Speciality
-
Taxonomy
251T00000X
License No.
()
Definition
A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights.
person
Provider's Taxonomy Details 2
Type
Transportation Services
Classification
Non-emergency Medical Transport (VAN)
Speciality
-
Taxonomy
343900000X
License No.
()
Definition
A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.
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