MEDICARE: SENIOR HAVEN ALF INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215297692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR HAVEN ALF INC

Provider Business Mailing Address
First Line	:	6745 SW 32ND TERRACE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-3837
Country	:	US
Telephone Number	:	305-915-1574
Fax Number	:

Provider Business Practice Location Address
First Line	:	6745 SW 32ND TERRACE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-3837
Country	:	US
Telephone Number	:	305-370-4578
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. ELAINE RODRIGUEZ
Credential	:
Telephone Number	:	305-370-4578

Provider Enumeration Date	:	05/21/2012
Last Update Date	:	12/14/2023

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Directions to “SENIOR HAVEN ALF INC ” Practice Location

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