OrganizationActive
Heidis Haven LLC
NPI 1073759890 · Assisted Living Facility · Lady Lake, FL
Provider details
- NPI number
- 1073759890
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Donald Johnson, Owner/ Administrator(828) 389-4915
- License
- AL10397 (FL)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
39106 Grays Airport Rd
Lady Lake, FL 32159-4004
Phone: (352) 787-3034
Fax: (352) 787-5979
Street-level locationGet directions
Mailing address
51 Barlow Fields Dr
Hayesville, NC 28904-9485
Other names (DBA / former)
- Doing business as
- Heidis Haven - Lady Lake
Registry dates
- Enumerated
- 2008-12-29
- Last updated
- 2016-09-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.