HEIDIS HAVEN LLC (NPI# 1255769840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255769840 |
| Entity Type | Organization |
| Organization Name | HEIDIS HAVEN LLC |
| Other Organization Name | HEIDIS HAVEN-LA SALIDA |
| Practice Address |
1215 La Salida Way Leesburg FL 34748-8272 |
| Practice Telephone | 3527873034 |
| Practice Fax Number | 3527875979 |
| Mailing Telephone | 3527873034 |
| Mailing Fax Number | 3527875979 |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2013-10-17 |
| Authorized Official Name | MR. DONALD WILLIAM JOHNSON (OWNER/ ADMINISTRATOR) |
| Authorized Official Telephone | 3527873034 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL11848 | FL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Heidis Haven-La Salida | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609204833 | Heidis Haven LLC | Assisted Living Facility | 1205 Bonaire Dr, Leesburg, FL 34748-5707 | 2013-10-25 |
| 1750719340 | Heidis Haven LLC | Assisted Living Facility | 36321 Grays Airport Rd, Fruitland Park, FL 34731-5418 | 2013-10-17 |
| 1073759890 | Heidis Haven LLC | Assisted Living Facility | 39106 Grays Airport Rd, Lady Lake, FL 32159-4004 | 2008-12-29 |
| Street Address |
1215 LA SALIDA WAY |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748-8272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074484 | Lubis Enterprise LLC | Assisted Living Facility | 1215 La Salida Way, Leesburg, FL 34748-8272 | 2020-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1467835900 | Serenity Choice Place, LLC | Community/Behavioral Health | 721 Balmoral Circle, Leesburg, FL 34748 | 2015-07-01 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| Find all providers in zip 34748 | ||||
| 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 |
|---|---|---|---|---|
| 1952937112 | Silver Lake Village, Inc | Assisted Living Facility | 34601 Radio Rd, Leesburg, FL 34788-3301 | 2020-03-19 |
| 1518359363 | Blue Haven Assisted Living, Inc | Assisted Living Facility | 35525 County Road 473, Leesburg, FL 34788-6161 | 2015-03-02 |
| 1609204833 | Heidis Haven LLC | Assisted Living Facility | 1205 Bonaire Dr, Leesburg, FL 34748-5707 | 2013-10-25 |
| 1215377759 | Tlc Family Care Home, Inc. | Assisted Living Facility | 34017 S Haines Creek Rd, Leesburg, FL 34788-4317 | 2013-06-28 |
| 1932548435 | Denly N, Inc. Dna Savannah Manor | Assisted Living Facility | 1027 W. Main St., Leesburg, FL 34748 | 2013-06-18 |
| 1770857500 | Morningside House of Leesburg | Assisted Living Facility | 316 Harrison St Se, Leesburg, VA 20175-3719 | 2012-02-24 |
| 1336431329 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 700 S Lake St, Leesburg, FL 34748-7321 | 2011-05-09 |
| 1114253754 | Shady Lane Retirement Home | Assisted Living Facility | 201 Rosefield Ave, Leesburg, FL 34748-5014 | 2009-11-01 |
| 1063672715 | Mayfield Retirement Center, Inc. | Assisted Living Facility | 460 Newell Hill Rd, Leesburg, FL 34748-9247 | 2008-06-16 |
| 1467074484 | Lubis Enterprise LLC | Assisted Living Facility | 1215 La Salida Way, Leesburg, FL 34748-8272 | 2020-05-13 |
| Find all providers in LEESBURG | ||||
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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.