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General NPI Number Information
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NPI Number | 1518117605
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Entity Type | Organization
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Legal Business Name | HEAVEN ON EARTH HOME HEALTH AGENCY INC
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 6800 BIG BEND LN
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City | ARLINGTON
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State | TX
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Zip | 76002-3510
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Country | US
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Telephone | 469-438-3293
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Fax |
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Provider Business Mailing Address
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Address Line | 6800 BIG BEND LN
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City | ARLINGTON
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State | TX
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Zip | 76002-3510
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Country | US
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Telephone | 469-438-3293
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE
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Name | MARTIN MBOE
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Credential | FNP
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Telephone | 469-438-3293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 012735
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License Number State | TX
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