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SEELYVILLE FAMILY PRACTICE
NPI 1316205115
Clinic/Center in Terre Haute, IN

Active since April 30, 2012
8810 WABASH AVE, TERRE HAUTE, IN 47803(812) 239-4090 Get Directions Write a Review

NPPES record last updated: April 30, 2012. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Seelyville Family Practice NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEELYVILLE FAMILY PRACTICE (NPI 1316205115) is a healthcare organization registered as a clinic/center in Terre Haute, Indiana and active in the NPI registry since April 2012. The organization lists Sherri Jernberg, Owner/operator, as its authorized official.

NPPES Registry Identity

NPI1316205115
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameFOUNTAIN OF YOUTH, LLC
Location Address8810 WABASH AVETerre Haute, IN 47803-3908
Mailing Address8810 Wabash AveTerre Haute, IN 47803-3908 · (812) 239-4090
Phone(812) 239-4090
Organization SubpartNo
Authorized OfficialSherri JernbergOwner/operator · (812) 239-4090
Enumeration DateApril 30, 2012
✔ NPI 1316205115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in IN · 71002624A
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
8810 WABASH AVE, Terre Haute, IN 47803
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Other Names 1

Doing Business AsSeelyville Family Practice

Other Identifiers 1

Other1588821250IN · Personal Npi Number

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fountain Of Youth, LLC's NPI number?

The NPI number for Fountain Of Youth, LLC is 1316205115. It was assigned to this organization in the NPPES registry on April 30, 2012. The provider is doing business as Seelyville Family Practice.

Where is Fountain Of Youth, LLC located?

Fountain Of Youth, LLC is located at 8810 Wabash Ave, Terre Haute, IN 47803. The listed phone number is (812) 239-4090.

What is Fountain Of Youth, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Fountain Of Youth, LLC was last updated on April 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.