Healthcare Provider Details

I. General information

NPI: 1508771262
Provider Name (Legal Business Name): ASSURED LIVING, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3488 BROMFIELD DR
OCOEE FL
34761-5105
US

IV. Provider business mailing address

634 CHAMPIONS GATE BLVD
DELAND FL
32724-8004
US

V. Phone/Fax

Practice location:
  • Phone: 689-305-4146
  • Fax:
Mailing address:
  • Phone: 689-305-4146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: TACARA DEWITT
Title or Position: DIRECTOR
Credential:
Phone: 689-305-4146