MEDICARE: HEAVEN SENT ASSISTED LIVING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1194314195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAVEN SENT ASSISTED LIVING LLC

Provider Business Mailing Address
First Line	:	901 ASPEN RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6107
Country	:	US
Telephone Number	:	561-633-9714
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 ASPEN RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6107
Country	:	US
Telephone Number	:	561-633-9714
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF NURSING
Name	:	NIRCHA DORCELY
Credential	:
Telephone Number	:	561-713-0881

Provider Enumeration Date	:	01/13/2021
Last Update Date	:	01/25/2021

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