Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fountain of Youth, LLC

Organization Clinic/Center · NPI 1316205115

Fountain of Youth, LLC is a Clinic/Center in Terre Haute, Indiana. Licensed in Indiana. Registered with an NPI since 2012.

Licensed in
IN
In the registry since
2012
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8810 Wabash Ave
Terre Haute, IN 47803-3908
Phone: (812) 239-4090
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X · Licence 71002624A (IN)

Record details

NPI number1316205115
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sherri Jernberg — Owner/Operator · (812) 239-4090
Other names Seelyville Family Practice
NPI enumeratedApril 30, 2012
Last updated in NPPESApril 30, 2012
Mailing address8810 Wabash Ave, Terre Haute, IN 47803-3908

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