Organization
HEAVENLY CHOICE ADULT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIA MORAME (CEO)
(863) 269-9753
Entity
Organization
Contact information
Practice address
5500 WATKINS RD, HAINES CITY, FL 33844-6254
(863) 269-9753
Mailing address
5500 WATKINS RD, HAINES CITY, FL 33844-6254
(863) 269-9753
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
6906270
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000422700
—
FL
Enumeration date
09/26/2012
Last updated
09/26/2012
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