Heidis Haven Llc

NPI 1073759890 - Assisted Living Facility - 310400000X

NPI Details
NPI 1073759890
Enumeration Date 12/29/2008
Last Updated 10/17/2013
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name DONALD WILLIAM DONALD
Position OWNER/ ADMINISTRATOR
Phone (352) 787-3034
Fax (352) 787-5979
Practice Location
39106 GRAYS AIRPORT RD
LADY LAKE FL, 32159-4004, US
Phone (352) 787-3034
Fax (352) 787-5979
Business Location
1215 LA SALIDA WAY
LEESBURG FL, 34748-8272, US
Phone (352) 787-3034
Fax (352) 787-5979
Toxanomy
Taxonomy Code 310400000X
License State Florida
License Number AL10397
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According to our database, Heidis Haven Llc NPI is 1073759890, taxonomy code is 310400000X and license number is AL10397, license state is located at Florida. Heidis Haven Llc physically located at 39106 Grays Airport Rd, Lady Lake FL, 32159-4004. NPI Number 1033115704 has the healthcare provider type.

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1073759890 NPI number is provided on an as is basis without warranty of any kind. 1073759890 is maintained by the National Plan & Provider Enumeration System. The contents of Heidis Haven Llc are for informational purposes only.