A HEAVENLY HOME, LLC (NPI# 1316414287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316414287 |
| Entity Type | Organization |
| Organization Name | A HEAVENLY HOME, LLC |
| Practice Address |
1046-1048 Nw 8th Ave Fort Lauderdale FL 33311-3331 |
| Mailing Address |
21135 Nw 14th Pl Apt 157 Miami Gardens FL 33169-2941 |
| Practice Telephone | 3053325034 |
| Mailing Telephone | 3053325034 |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |
| Authorized Official Name | MS. CHARICE V DUCTANT (OWNER) |
| Authorized Official Telephone | 3053325034 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| A Heavenly Home, LLC | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104487784 | A Heavenly Home, LLC | Assisted Living Facility | 1920 Prospect Ave, Paso Robles, CA 93446-6343 | 2019-06-25 |
| Street Address |
1046-1048 NW 8TH AVE |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33311-3331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699390336 | Rosenie B Jasmin | Family Medicine | Dove Medical Centers, LLC, 2901 West Oakland Park Blvd Ste A4-5, Oakland Park, FL 33311 | 2020-06-09 |
| 1942769534 | Cbd Skeletal Solutions, LLC | Durable Medical Equipment & Medical Supplies | 630 Tennis Club Drive, Outerbridge - 407, Ft. Lauderdale, FL 33311 | 2019-03-14 |
| 1770049116 | Jordan Matthew Nodelman | Social Worker | 871 W Oakland Park Boulevard, Oakland Park, FL 33311 | 2019-02-11 |
| 1417422304 | Carebridge Home Health of Flrorida | Home Health | 1871 West Oakland Park Blvd, Suite E, Oakland Park, FL 33311 | 2018-10-08 |
| 1992287130 | Michael Ray Johnson | Counselor | 900 Nw 31 Ave, Suite #2000, Ft Laud, FL 33311 | 2018-09-04 |
| 1477047058 | Latino Medical Center IIi | General Practice | 3670 W Oakland Blvd, Lauderdale Lakes, FL 33311 | 2018-06-18 |
| 1316442049 | Anita Fox | Non-emergency Medical Transport (VAN) | 2880 West Oakland Park Blvd, 234, Oakland Park, FL 33311 | 2018-03-26 |
| 1669995957 | Lola J Lewis-walker | Nurse Practitioner | 925 Nw 14th St, Fort Lauderdale, FL 33311 | 2017-07-19 |
| 1598294936 | Abigail D Garcia | Counselor | 713 Nw 1st Ave, Fort Lauderdale, FL 33311 | 2017-06-08 |
| 1548712524 | Hubert Faustin | Counselor | 1409 Nw 1st Avenue, Fort Lauderdale, FL 33311 | 2016-10-26 |
| Find all providers in zip 33311 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396119004 | Majestic On The River LLC | Assisted Living Facility | 408 Sw 7th Ave, Fort Lauderdale, FL 33312-2567 | 2015-11-18 |
| 1568880565 | 2065 Inc Dba Fort Lauderdale Retirement Home | Assisted Living Facility | 401 Se 12th Ct, Fort Lauderdale, FL 33316-1919 | 2014-04-07 |
| 1891038030 | Towers Retirement Home | Assisted Living Facility | 824 Se 2nd St, Fort Lauderdale, FL 33301-3606 | 2013-04-05 |
| 1881954659 | Kelly's Assisted Living Facility | Assisted Living Facility | 1451 Nw 20th St, Fort Lauderdale, FL 33311-3523 | 2012-05-25 |
| 1871745265 | Total Care Manor, Inc | Assisted Living Facility | 1490 Nw 21 Street, Fort Lauderdale, FL 33311 | 2008-10-16 |
| 1871615690 | Jeanrob Corp | Assisted Living Facility | 408 Cooley Ave, Fort Lauderdale, FL 33312-2567 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952910200 | Darielle Shanette Berrian | Assisted Living Facility | 1548 Georgetown Dr, Lakeland, FL 33811 | 2020-07-23 |
| 1003434028 | Carolyn Clanton Alf LLC | Assisted Living Facility | 1146 Hamilton Ave, Jennings, FL 32053-2253 | 2020-07-07 |
| 1356964555 | Cordoba Alf LLC | Assisted Living Facility | 1135 Sw 100th Ct, Miami, FL 33174-2848 | 2020-05-21 |
| 1205461563 | Alegria Alf LLC | Assisted Living Facility | 1150 Sw 103rd Ct, Miami, FL 33174-2759 | 2020-03-06 |
| 1134764368 | Aum Haven LLC | Assisted Living Facility | 2763 Carmel Ct, Kissimmee, FL 34746-3268 | 2019-11-12 |
| 1275180515 | 1161 Cambridge LLC | Assisted Living Facility | 1161 W 2nd St, Riviera Beach, FL 33404-7627 | 2019-08-21 |
| 1386291623 | Cambridge 13 LLC | Assisted Living Facility | 1560 W 13th St, Riviera Beach, FL 33404-6521 | 2019-08-21 |
| 1851948418 | 3411 Ave Cambridge LLC | Assisted Living Facility | 3411 Avenue H E, Riviera Beach, FL 33404-2101 | 2019-08-19 |
| 1326694308 | W 2nd Cambridge LLC | Assisted Living Facility | 570 W 2nd St, Riviera Beach, FL 33404-7616 | 2019-08-14 |
| 1154976512 | Quality Health Care of Florida.llc | Assisted Living Facility | 1250 Nw 122nd Ave, Plantation, FL 33323-2420 | 2019-08-02 |
| Find all providers with the same taxonomy | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33311 |
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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.