Healthcare Provider Details

I. General information

NPI: 1649963943
Provider Name (Legal Business Name): HEAVEN ON EARTH HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 ELKRIDGE LANDING RD STE 210
LINTHICUM HEIGHTS MD
21090-2912
US

IV. Provider business mailing address

1749 WOOD CARRIAGE WAY
SEVERN MD
21144-5016
US

V. Phone/Fax

Practice location:
  • Phone: 443-410-8454
  • Fax:
Mailing address:
  • Phone: 443-410-8454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CHANEKA NICOLE BROWN
Title or Position: OWNER/OPERATOR
Credential:
Phone: 443-410-8454