Organization
HEAVENLY ADULT DAY CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARIEL MORA (CEO)
(786) 287-2359
Entity
Organization
Contact information
Practice address
20 SE 4TH RD, HOMESTEAD, FL 33030-7301
(786) 601-7302
(786) 504-3349
Mailing address
20 SE 4TH RD, HOMESTEAD, FL 33030-7301
(786) 601-7302
(786) 504-3349
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115054000
—
FL
01
—
9544
AHCA LICENSE
FL
Enumeration date
09/01/2022
Last updated
09/01/2022
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