Healthcare Provider Details

I. General information

NPI: 1508553454
Provider Name (Legal Business Name): HEAVENLY HAND SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14062 HIGHWAY 16 W
DE KALB MS
39328-7922
US

IV. Provider business mailing address

16165 HIGHWAY 51
HAZLEHURST MS
39083-2002
US

V. Phone/Fax

Practice location:
  • Phone: 601-894-1120
  • Fax: 844-270-3071
Mailing address:
  • Phone: 601-894-1120
  • Fax: 844-270-3071

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 Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: CAROL P NEWTON
Title or Position: EXECUTIVE DIRECTOR
Credential: ED. S.
Phone: 601-894-1120