Ursula'S Haven Assisted Living Facility, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12946 Issued in FL

Legal business name

URSULA'S HAVEN ASSISTED LIVING FACILITY, INC

Practice address

11900 NW 35TH St
Sunrise, FL 33323-1242

Phone

(954) 639-3611

Fax

(954) 746-2544

NPI assigned

Jan 22, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Ursula Schmiel-Degama, LPNNPI 1699212399

Title

Administrator-Owner

Phone

(954) 639-3611

Specialties & licenses 2

Addresses

Other names 1

• Ursula's Haven II ALF Doing business as

Tax ID family

Ursula'S Haven Assisted Living Facility Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ursula'S Haven Assisted Living Facility, Inc

  • Assisted Living Facility
  • Sunrise, FL
  • NPI 1255179685
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ursula Schmiel-Degama, LPN

  • Nursing Home Administrator
  • Sunrise, FL
  • NPI 1699212399
  NPD Authorized official

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

{
    "created_epoch": "1485043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1760929376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 NW 35TH ST",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333231242",
            "telephone_number": "954-639-3611",
            "fax_number": "954-746-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 NW 35TH ST",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333231242",
            "telephone_number": "954-639-3611",
            "fax_number": "954-746-2544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10620 NW 32nd St",
            "address_purpose": "LOCATION",
            "city": "Sunrise",
            "state": "FL",
            "postal_code": "333516852",
            "country_code": "US",
            "telephone_number": "954-732-6246",
            "fax_number": "954-990-8860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "URSULA'S HAVEN ASSISTED LIVING FACILITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-22",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "SCHMIEL-DEGAMA",
        "authorized_official_first_name": "URSULA",
        "authorized_official_title_or_position": "ADMINISTRATOR-OWNER",
        "authorized_official_telephone_number": "954-639-3611",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12946",
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ursula's Haven II ALF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Natalie Marie VA, PH.D.
• Kevin Joseph Vaccarello, PA-C

• Assisted Living Facility in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.