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General NPI Number Information
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NPI Number | 1396081709
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Entity Type | Organization
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Legal Business Name | HEAVENLY CARE STAFFING
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Dates
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Enumeration Date | 12/13/2012
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Last Update Date | 12/13/2012
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Provider Practice Location Address
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Address Line | 6710 WINDFIELD GAP
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City | CONVERSE
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State | TX
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Zip | 78109-3531
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Country | US
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Telephone | 210-888-1976
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Fax |
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Provider Business Mailing Address
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Address Line | 6710 WINDFIELD GAP
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City | CONVERSE
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State | TX
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Zip | 78109-3531
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Country | US
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Telephone | 210-888-1976
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. MELVIN EUGENE WHITE
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Credential |
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Telephone | 210-837-6058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | TX
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