Fountain of Youth Activity Center, LLC
NPI 1134797715 · PACE Provider Organization · Raytown, MO
Fountain of Youth Activity Center, LLC is a PACE Provider Organization organization in Raytown, MO (NPI 1134797715).
Provider details
- NPI number
- 1134797715
- Entity type
- Organization
- Primary specialty
- PACE Provider OrganizationAgencies
- Organization subpart
- No
- Authorized official
- John Parker, Executive Director(816) 503-9865
Specialties & taxonomies
Agencies
- Non-emergency Medical Transport (VAN)343900000X
Transportation Services
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2021-06-11
- Last updated
- 2021-06-11
- Certified
- 2021-06-11
Frequently asked questions
- What is Fountain of Youth Activity Center, LLC's NPI number?
- Fountain of Youth Activity Center, LLC's National Provider Identifier (NPI) is 1134797715, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fountain of Youth Activity Center, LLC?
- Fountain of Youth Activity Center, LLC is classified in the NPPES registry as PACE Provider Organization (Agencies).
- Where is Fountain of Youth Activity Center, LLC located?
- Fountain of Youth Activity Center, LLC's practice location on file with NPPES is 8801 E 63rd St Ste 101, Raytown, MO 64133-4865.
- What is Fountain of Youth Activity Center, LLC's phone number?
- The practice phone number listed in the NPPES registry for Fountain of Youth Activity Center, LLC is (816) 886-0442.
- Who is the authorized official for Fountain of Youth Activity Center, LLC?
- The authorized official listed on Fountain of Youth Activity Center, LLC's NPPES record is John Parker, Executive Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fountain of Youth Activity Center, LLC's NPI active?
- Yes — Fountain of Youth Activity Center, LLC's NPI (1134797715) is active in the NPPES registry as of the last update on 2021-06-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.