Healthcare Provider Details

I. General information

NPI: 1750932372
Provider Name (Legal Business Name): HEAVENLY CARING HANDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 HIGHWAY 51 STE U
MADISON MS
39110-8437
US

IV. Provider business mailing address

1000 HIGHLAND COLONY PKWY STE 5203
RIDGELAND MS
39157-2079
US

V. Phone/Fax

Practice location:
  • Phone: 601-707-6772
  • Fax:
Mailing address:
  • Phone: 601-897-0345
  • Fax: 601-897-0349

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 Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LATOYA MERSANDUIS WINDOM
Title or Position: CEO AND FOUNDER/ADMINISTRATOR
Credential:
Phone: 601-707-6772