Provider Demographics
NPI:1649415860
Name:HEAVEN SENT ASSISTANT LIVING INC.
Entity Type:Organization
Organization Name:HEAVEN SENT ASSISTANT LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:LARREN
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:407-497-0915
Mailing Address - Street 1:4123 RALEIGH ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-4144
Mailing Address - Country:US
Mailing Address - Phone:407-497-0915
Mailing Address - Fax:407-886-4543
Practice Address - Street 1:4123 RALEIGH ST.
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811
Practice Address - Country:US
Practice Address - Phone:407-497-0915
Practice Address - Fax:407-886-4543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230884251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health