Healthcare Provider Details

I. General information

NPI: 1790299477
Provider Name (Legal Business Name): HEAVENLY STAFFING CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2017
Last Update Date: 11/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7436 SILVERADO DR
MARRERO LA
70072-5976
US

IV. Provider business mailing address

PO BOX 1735
MARRERO LA
70073-1735
US

V. Phone/Fax

Practice location:
  • Phone: 504-208-6944
  • Fax: 504-304-9357
Mailing address:
  • Phone: 504-208-6944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LIZ MITCHELL
Title or Position: OWNER OPERATOR
Credential:
Phone: 504-208-6944