NPIMap

Organization Active NPI

Havencrest Alf, LLC

  • Assisted Living Facility
  • Coconut Creek, FL
National Provider Identifier
1245677780
Registry record updated May 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL10229 Issued in FL
Legal business name
HAVENCREST ALF, LLC
Practice address
4471 Coconut Creek Blvd
Coconut Creek, FL 33066-1742
Phone
(954) 971-4289
Fax
(954) 345-7123
NPI assigned
May 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yvonne Johnson
Title
Owner
Phone
(954) 683-3945

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL10229 FL Primary

Addresses

Primary practice location

4471 Coconut Creek Blvd
Coconut Creek, FL 33066-1742

Mailing address

4471 Coconut Creek Blvd
Coconut Creek, FL 33066-1742
Phone (954) 971-4289

Other names 1

  • Havencrest ALF III Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369267200000",
    "number": "1245677780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4471 COCONUT CREEK BLVD",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661742",
            "telephone_number": "954-971-4289",
            "fax_number": "954-345-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4471 COCONUT CREEK BLVD",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661742",
            "telephone_number": "954-971-4289",
            "fax_number": "954-345-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENCREST ALF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-23",
        "last_updated": "2013-05-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-683-3945"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Havencrest ALF III",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.