Healthcare Provider Details

I. General information

NPI: 1497373427
Provider Name (Legal Business Name): HEAVEN OF HOPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 07/17/2020
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 FRANKLIN AVE
ALIQUIPPA PA
15001-3728
US

IV. Provider business mailing address

PO BOX 1032
ALIQUIPPA PA
15001-0832
US

V. Phone/Fax

Practice location:
  • Phone: 724-203-0685
  • Fax: 724-203-0706
Mailing address:
  • Phone: 724-203-0685
  • Fax: 724-203-0706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: VINCENT HARMON
Title or Position: OWNER
Credential:
Phone: 724-203-0685