LULA FRAZIER (NPI# 1104327873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104327873 |
| Entity Type | Organization |
| Organization Name | LULA FRAZIER |
| Other Organization Name | SAFE HAVEN OAKS ASSISTED LIVING FACILITY, LLC. |
| Practice Address |
409 S Lincoln St Bushnell FL 33513-7109 |
| Practice Telephone | 3524603529 |
| Practice Fax Number | 3525089798 |
| Mailing Telephone | 3524603529 |
| Mailing Fax Number | 3525089798 |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | LULA FRAZIER (OWNER) |
| Authorized Official Telephone | 3524603529 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 811354531 | 05 |
| Other Name | Type Code |
|---|---|
| M & L Independent Living, LLC. | Former Legal Business Name - Organization |
| Safe Haven Oaks Assisted Living Facility, LLC. | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538660154 | Lula Frazier | Home Health | 1326 Wn Blvd, Suite 11, Leesburg, FL 34748-4944 | 2018-02-28 |
| Street Address |
409 S LINCOLN ST |
| City | BUSHNELL |
| State | FL |
| Zip Code | 33513-7109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033680558 | Safe Haven Oaks, Inc. | Assisted Living Facility | 409 S Lincoln St, Bushnell, FL 33513-7109 | 2018-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619465481 | Crystal Wallace Goddin | Physical Therapy Assistant | 1104 N Main St, Bushnell, Fl, Bushnell, FL 33513 | 2018-04-27 |
| 1255836920 | Anton Dawson | Behavior Technician | 2310 Cr 615, Bushnell, FL 33513 | 2018-03-26 |
| 1942728431 | Carolyn Sue Guarino | Licensed Practical Nurse | 10306 S.w. 53rd Terr., Bushnell, FL 33513 | 2017-09-05 |
| 1326321258 | Edith Marie Evans | Case Manager/Care Coordinator | 2891 C.r. 615b, Bushnell, FL 33513 | 2011-09-27 |
| 1144478439 | Emma J Ridley | Pharmacist | Sumter Oaks Park, 4602 Couny Rd. 673, #14107, Bushnell, FL 33513 | 2008-08-29 |
| 1205083268 | Diana K Mullin | Day Training, Developmentally Disabled Services | 9325 Cr 622 G, Bushnell, FL 33513 | 2008-08-21 |
| 1467625202 | Amy's Caring Hands | Day Training, Developmentally Disabled Services | 1612 W County Road 476, Bushnell, FL 33513 | 2008-04-11 |
| 1821212952 | Stuart J Kaufman Md & Assoc Pa | Ophthalmology | 1814 West Cr 48, Bushnell, FL 33513 | 2007-04-12 |
| 1740201128 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 1122 N Main St, Bushnell, FL 33513 | 2006-07-21 |
| 1184688947 | Florida Department of Health | Public Health or Welfare | 415 E Noble Ave, Bushnell, FL 33513 | 2006-04-17 |
| Find all providers in zip 33513 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033680558 | Safe Haven Oaks, Inc. | Assisted Living Facility | 409 S Lincoln St, Bushnell, FL 33513-7109 | 2018-12-10 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.