MEDICARE: MAY FOREST HAVEN LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	385H00000X	Respite Care
2	385HR2065X	Child Physical Disabilities Respite Care
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1285578138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAY FOREST HAVEN LLC

Provider Business Mailing Address
First Line	:	1021 W 13TH ST
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-2605
Country	:	US
Telephone Number	:	863-393-6310
Fax Number	:

Provider Business Practice Location Address
First Line	:	1021 W 13TH ST
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-2605
Country	:	US
Telephone Number	:	863-393-6310
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHIETH D EVANS
Credential	:
Telephone Number	:	863-393-6310

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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Directions to “MAY FOREST HAVEN LLC ” Practice Location

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