| NPI | 1023310372 |
|---|---|
| Doing Business As | FOREVER YOUNG |
| Entity Type | Organization |
| Authorized Contact | TROY LEE YOUNG Owner,CEO 480-888-0456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AZ AL8195H) |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2010-11-18 |