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General NPI Number Information
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NPI Number | 1023324480
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Entity Type | Organization
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Legal Business Name | HEAVEN SENT HOMECARE SENIOR SERVICES
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 71 RANDOLPH DRIVE
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City | PALM COAST
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State | FL
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Zip | 32164
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Country | US
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Telephone | 386-785-4040
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Fax | 386-313-6190
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Provider Business Mailing Address
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Address Line | 71 RANDOLPH DRIVE
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City | PALM COAST
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State | FL
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Zip | 32164
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Country | US
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Telephone | 386-785-4040
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Fax | 386-313-6190
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHRISTINA ROSE CARLOUGH
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Credential |
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Telephone | 386-785-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 231817
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License Number State | FL
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