Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Heavenly Assisted Living, Inc

Organization Assisted Living Facility · NPI 1407467806

Heavenly Assisted Living, Inc is an Assisted Living Facility in Port Orange, Florida. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

401 Orange Ave
Port Orange, FL 32127-4444
Phone: (386) 761-6268
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X

Record details

NPI number1407467806
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Yohannes Fissiha — Owner · (386) 767-6268
NPI enumeratedAugust 11, 2020
Last updated in NPPESAugust 24, 2020
Certification dateAugust 24, 2020
Mailing address401 Orange Ave, Port Orange, FL 32127-4444

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