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General NPI Number Information
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NPI Number | 1831658889
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Entity Type | Organization
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Legal Business Name | VICTORIA'S 7TH HEAVEN. LLC
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 11235 SE HIGHWAY 42
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City | SUMMERFIELD
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State | FL
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Zip | 34491-6628
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Country | US
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Telephone | 407-906-2904
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Fax |
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Provider Business Mailing Address
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Address Line | 673 CRYSTAL BAY LN
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City | ORLANDO
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State | FL
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Zip | 32828-6660
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Country | US
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Telephone | 407-222-3058
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MONIQUE BRYANT
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Credential | BSN, RN
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Telephone | 407-222-3058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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