Heidis Haven LLC
NPI #1750719340 in Fruitland Park, Florida
Provider Information
- NPI Number
- 1750719340
- Entity Type
- Organization
- Organization Name
- Heidis Haven LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Oct 17, 2013
- Last Updated
- Oct 17, 2013
Practice Location
- Address
- 36321 GRAYS AIRPORT RD
- City
- Fruitland Park
- State
- Florida
- ZIP Code
- 34731-5418
- Phone
- (352) 787-3034
Authorized Official
- Name
- MR. DONALD WILLIAM JOHNSON
- Title
- OWNER/ ADMINISTRATOR
- Phone
- (352) 787-3034
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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