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GUARDIAN HAVEN ACADEMY NPI 1871087080


NPI Information

NPI: 1871087080
Provider Name: GUARDIAN HAVEN ACADEMY

Doing Business As: GUARDIAN HAVEN

Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization
Address:
3801 CORPOREX PARK DR STE 200
TAMPA, FL
ZIP 33619
Phone: (813) 400-2117
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GUARDIAN HAVEN ACADEMY is a day training developmentally disabled services in Tampa, FL. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. GUARDIAN HAVEN ACADEMY NPI is 1871087080. The provider is registered as an organization entity type.
The provider Is Doing Business As Guardian Haven.

The provider's business location address is:

3801 CORPOREX PARK DR STE 200
TAMPA, FL
ZIP 33619-136
Phone: (813) 400-2117

The provider's authorized official is Nakisha Lavell Varlack .
The authorized official title is Owner and has the following contact phone number (813) 400-2117.

The enumeration date for this NPI number is 6/20/2018 and was last updated on 9/27/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251C00000XDay Training, Developmentally Disabled ServicesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1100069300MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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