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HEIDIS HAVEN-FRUITLAND PARK
NPI 1750719340
Assisted Living Facility in Fruitland Park, FL

Active since October 17, 2013
36321 GRAYS AIRPORT RD, FRUITLAND PARK, FL 34731(352) 787-3034(352) 787-3034 Get Directions Write a Review

NPPES record last updated: October 17, 2013. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Heidis Haven-fruitland Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEIDIS HAVEN-FRUITLAND PARK (NPI 1750719340) is a healthcare organization registered as an assisted living facility in Fruitland Park, Florida and active in the NPI registry since October 2013. The organization lists Donald William Johnson, Owner/ Administrator, as its authorized official.

NPPES Registry Identity

NPI1750719340
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameHEIDIS HAVEN LLC
Location Address36321 GRAYS AIRPORT RDFruitland Park, FL 34731-5418
Mailing Address1215 La Salida WayLeesburg, FL 34748-8272 · (352) 787-3034 · Fax (352) 787-5979
Phone(352) 787-3034
Fax(352) 787-3034
Organization SubpartNo
Authorized OfficialDonald William JohnsonOwner/ Administrator · (352) 787-3034
Enumeration DateOctober 17, 2013
✔ NPI 1750719340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in FL · AL11978
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
36321 GRAYS AIRPORT RD, Fruitland Park, FL 34731
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Other Names 1

Doing Business AsHeidis Haven-fruitland Park

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LUBIS ENTERPRISE LLC
Assisted Living Facility
36321 GRAYS AIRPORT RD
FRUITLAND PARK, FL 34731
Lake County (352) 460-0754

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heidis Haven LLC's NPI number?

The NPI number for Heidis Haven LLC is 1750719340. It was assigned to this organization in the NPPES registry on October 17, 2013. The provider is doing business as Heidis Haven-Fruitland Park.

Where is Heidis Haven LLC located?

Heidis Haven LLC is located at 36321 Grays Airport Rd, Fruitland Park, FL 34731. The listed phone number is (352) 787-3034.

What is Heidis Haven LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Heidis Haven LLC was last updated on October 17, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.