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General NPI Number Information
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NPI Number | 1649415860
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Entity Type | Organization
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Legal Business Name | HEAVEN SENT ASSISTANT LIVING INC.
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 12/03/2008
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Provider Practice Location Address
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Address Line | 4123 RALEIGH ST.
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City | ORLANDO
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State | FL
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Zip | 32811
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Country | US
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Telephone | 407-497-0915
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Fax | 407-886-4543
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Provider Business Mailing Address
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Address Line | 4123 RALEIGH ST
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City | ORLANDO
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State | FL
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Zip | 32811-4144
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Country | US
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Telephone | 407-497-0915
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Fax | 407-886-4543
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SAMUEL LARREN STEELE I
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Credential |
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Telephone | 407-497-0915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 230884
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License Number State | FL
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