# HAVENCREST ALF INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124394440
- **Authorized official:** MRS. YVONNE G JOHNSON (OWNER)
- **Authorized official phone:** (954) 683-3945

## Contact information

- **Practice address:** 4280 NW 113TH AVE, CORAL SPRINGS, FL 33065-7778
- **Practice address phone:** (954) 683-3945
- **Mailing address:** 4280 NW 113TH AVE, CORAL SPRINGS, FL 33065-7778
- **Mailing address phone:** (954) 683-3945

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/30/2012
- **Last updated:** 03/30/2012