Healthcare Provider Details

I. General information

NPI: 1447195169
Provider Name (Legal Business Name): HEARTFUL HAVEN COMPANION CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39712 RIVER RD
DADE CITY FL
33525-7192
US

IV. Provider business mailing address

39712 RIVER RD
DADE CITY FL
33525-7192
US

V. Phone/Fax

Practice location:
  • Phone: 352-652-2841
  • Fax:
Mailing address:
  • Phone: 352-652-2841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: PRISCILLA CONTRERAS
Title or Position: OWNER
Credential:
Phone: 352-652-2841