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General NPI Number Information
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NPI Number | 1427704493
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Entity Type | Organization
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Legal Business Name | HEAVENLY HOME CARE SERVICES, LLC
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Dates
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Enumeration Date | 02/28/2022
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 247 28TH ST # 207
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City | NEWPORT NEWS
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State | VA
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Zip | 23607-3907
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Country | US
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Telephone | 757-577-5122
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5695
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City | NEWPORT NEWS
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State | VA
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Zip | 23605-0695
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Country | US
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Telephone | 757-952-9605
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATION
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Name | MR. ERIC WOODS
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Credential | CNA/MEDTECH
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Telephone | 757-952-9605
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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 |
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License Number State |
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