A Heavenly Home, LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

A HEAVENLY HOME, LLC

Practice address

1046-1048 NW 8TH Ave
Fort Lauderdale, FL 33311-3331

Phone

(305) 332-5034

NPI assigned

Oct 30, 2018

Last updated

Oct 30, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Charice V Ductant

Title

Owner

Phone

(305) 332-5034

Specialties & licenses 1

Addresses

Other names 1

• A Heavenly Home, LLC Former legal business name

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1316414287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21135 NW 14TH PL APT 157",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331692941",
            "telephone_number": "305-332-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046-1048 NW 8TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333113331",
            "telephone_number": "305-332-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A HEAVENLY HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "DUCTANT",
        "authorized_official_first_name": "CHARICE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-332-5034",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Heavenly Home, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Assisted Living Facility (Mental Illness) in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.