Healthcare Provider Details

I. General information

NPI: 1316827991
Provider Name (Legal Business Name): SENIOR HAVEN DAY CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511 W VIRGINIA AVE STE B
TAMPA FL
33607-6310
US

IV. Provider business mailing address

2511 W VIRGINIA AVE STE B
TAMPA FL
33607-6310
US

V. Phone/Fax

Practice location:
  • Phone: 813-252-7713
  • Fax: 813-443-0145
Mailing address:
  • Phone: 813-252-7713
  • Fax: 813-443-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ADDRYS ABELLA TORRES
Title or Position: ADMINISTRATOR
Credential:
Phone: 813-390-9873