Provider Demographics
NPI:1619398112
Name:HANNAH'S HEART ASSISTED LIVING
Entity Type:Organization
Organization Name:HANNAH'S HEART ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREENETTE
Authorized Official - Middle Name:DELILAH
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-588-0329
Mailing Address - Street 1:17383 SW 47TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5055
Mailing Address - Country:US
Mailing Address - Phone:305-588-0329
Mailing Address - Fax:
Practice Address - Street 1:17383 SW 47TH CT
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5055
Practice Address - Country:US
Practice Address - Phone:305-588-0329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-31
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11004310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility