BLUE HAVEN ASSISTED LIVING, INC (NPI# 1518359363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518359363 |
| Entity Type | Organization |
| Organization Name | BLUE HAVEN ASSISTED LIVING, INC |
| Practice Address |
35525 County Road 473 Leesburg FL 34788-6161 |
| Mailing Address |
33409 Irongate Dr Leesburg FL 34788-3158 |
| Practice Telephone | 3523140422 |
| Practice Fax Number | 3523140423 |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2015-03-02 |
| Authorized Official Name | LEYTONYA HARGROVE (ADMINISTRATOR) |
| Authorized Official Telephone | 3524093585 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL11984 | FL | Nursing & Custodial Care Facilities |
| Street Address |
35525 COUNTY ROAD 473 |
| City | LEESBURG |
| State | FL |
| Zip Code | 34788-6161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346752060 | Latoya Luella Burnette | Homemaker | 9324 Cemetery Ave, Leesburg, FL 34788 | 2017-11-03 |
| 1407396781 | Rachelle Desir | Developmental Therapist | 33242 Kaylee Way, Leesburg, FL 34788 | 2017-03-06 |
| 1184752750 | Suzanne Mary Howard | Social Worker | 33057 Professional Drive, Lake Center of Hope, Leesburg, FL 34788 | 2007-03-02 |
| 1386798460 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 10041 Us Hwy 441, Suite E, Leesburg, FL 34788 | 2007-01-23 |
| 1558412486 | Samuel Bundz Md Pa | Surgery | 8112 Centralia Ct, Suite 101, Leesburg, FL 34788 | 2007-01-16 |
| 1174628481 | Foy Edward Dark Jr. | Chiropractor | 32629 Blossom Lane, Leesburg, FL 34788 | 2006-09-13 |
| 1033220744 | Miguel A Gonzalez | Internal Medicine | 33025 Professional Drive, Leesburg, FL 34788 | 2006-08-31 |
| 1215968821 | N Chandramohan Md Pa | Internal Medicine | 32845 Radio Road, Ste 102, Leesburg, FL 34788 | 2006-07-05 |
| 1548296361 | Endosurg Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | 8100 Cr 44 Leg A, Leesburg, FL 34788 | 2006-06-23 |
| 1629014956 | Steven Joseph Nerad | Technician, Cardiology | 8135 Centralia Court, Suite 102, Leesburg, FL 34788 | 2006-06-22 |
| Find all providers in zip 34788 | ||||
| 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 |
| 1609204833 | Heidis Haven LLC | Assisted Living Facility | 1205 Bonaire Dr, Leesburg, FL 34748-5707 | 2013-10-25 |
| 1255769840 | Heidis Haven LLC | Assisted Living Facility | 1215 La Salida Way, Leesburg, FL 34748-8272 | 2013-10-17 |
| 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.