Provider Demographics
NPI:1538963426
Name:YOUNG, LATOYA R
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:R
Last Name:YOUNG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CARDINAL CT
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-8905
Mailing Address - Country:US
Mailing Address - Phone:404-514-8250
Mailing Address - Fax:
Practice Address - Street 1:100 CARDINAL CT
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-8905
Practice Address - Country:US
Practice Address - Phone:404-514-8250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care