Healthcare Provider Details

I. General information

NPI: 1497680235
Provider Name (Legal Business Name): CARING HEARTS ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1636 E SHANGRI LA DR
DAYTONA BEACH FL
32119-1520
US

IV. Provider business mailing address

1636 E SHANGRI LA DR
DAYTONA BEACH FL
32119-1520
US

V. Phone/Fax

Practice location:
  • Phone: 386-868-7225
  • Fax: 386-868-7225
Mailing address:
  • Phone: 386-868-7225
  • Fax: 386-868-7225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: MS. EDITHA IGNACIO
Title or Position: ADMINISTRATOR
Credential: IGNACIO
Phone: 386-868-7225