MEDICARE: WARMHAVEN, 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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1710844295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARMHAVEN, LLC

Provider Business Mailing Address
First Line	:	2120 PRESTON LN
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-0018
Country	:	US
Telephone Number	:	727-492-3725
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 PRESTON LN
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-0017
Country	:	US
Telephone Number	:	727-492-3725
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	JACKIE TELFAIR
Credential	:
Telephone Number	:	727-492-3725

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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