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Yohannes Fissiha
Assisted Living Facility in Port Orange, Florida
NPI 1295346690

Yohannes Fissiha is an Assisted Living Facility based in Port Orange, FL. Yohannes Fissiha practices in Port Orange, FL. The NPI Number for Yohannes Fissiha is 1295346690 and holds a License No. AL6084 (Florida).

The current practice location address for Yohannes Fissiha is 401 Orange Ave, Port Orange, FL and can be reached out via phone at 386-767-6268.

Location: 401 Orange Ave, Port Orange, FL, 32127-4444
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1295346690
Provider Name
Yohannes Fissiha
Credential
Provider Entity Type
Individual
Gender
Male
Address
401 Orange Ave, Port Orange, FL, 32127-4444
Phone Number
386-767-6268
Fax Number
Provider Enumeration Date
08/11/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
401 Orange Ave
City
Port Orange
State
Florida
Zip
32127-4444
Phone Number
386-767-6268
Fax Number
person
Provider Business Mailing Address Details
Address
401 Orange Ave
City
Port Orange
State
Florida
Zip
32127-4444
Phone Number
386-767-6268
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
AL6084 (Florida)
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.
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