Healthcare Provider Details

I. General information

NPI: 1356571244
Provider Name (Legal Business Name): HEAVENSENT HOME HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2009
Last Update Date: 07/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 STONEMINT CT
SIMPSONVILLE SC
29680-7323
US

IV. Provider business mailing address

PO BOX 5892
GREENVILLE SC
29606-5892
US

V. Phone/Fax

Practice location:
  • Phone: 864-346-4252
  • Fax:
Mailing address:
  • Phone: 864-346-4252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. JOY MADONNA LADSON
Title or Position: MANAGER
Credential:
Phone: 864-346-4252