Organization
HEIDIS HAVEN LLC
Active
Other names
Heidis Haven - Lady Lake
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD WILLIAM JOHNSON (OWNER/ ADMINISTRATOR)
(828) 389-4915
Entity
Organization
Contact information
Practice address
39106 GRAYS AIRPORT RD, LADY LAKE, FL 32159-4004
(352) 787-3034
(352) 787-5979
Mailing address
51 BARLOW FIELDS DR, HAYESVILLE, NC 28904-9485
(828) 389-4915
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10397
FL
Other
Enumeration date
12/29/2008
Last updated
09/14/2016
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