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General NPI Number Information
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NPI Number | 1073489159
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Entity Type | Organization
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Legal Business Name | YOUR HOME ASSISTED LIVING LLC
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Dates
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Enumeration Date | 10/15/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 2005 W AIRPORT BLVD
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City | SANFORD
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State | FL
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Zip | 32771-4035
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Country | US
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Telephone | 407-314-6599
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Fax |
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Provider Business Mailing Address
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Address Line | 1672 KERSLEY CIR
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City | LAKE MARY
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State | FL
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Zip | 32746-1923
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Country | US
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Telephone | 407-314-6599
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NIKIA WILLIAMS
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Credential | ARNP
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Telephone | 407-314-6599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SL0600X
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Taxonomy Name | Long-Term Care Clinical Nurse Specialist
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License Number |
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License Number State |
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