Provider Demographics
NPI:1689213605
Name:HAVEN ALF, INC.
Entity Type:Organization
Organization Name:HAVEN ALF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RONNIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPIGUL GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-343-1991
Mailing Address - Street 1:1514 HAVEN BND
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1133
Mailing Address - Country:US
Mailing Address - Phone:813-343-1991
Mailing Address - Fax:813-284-5459
Practice Address - Street 1:1514 HAVEN BND
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1133
Practice Address - Country:US
Practice Address - Phone:813-343-1991
Practice Address - Fax:813-284-5459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility