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General NPI Number Information
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NPI Number | 1538315205
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Entity Type | Organization
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Legal Business Name | HEAVENLY TOUCH LLC
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Dates
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Enumeration Date | 08/13/2008
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 15700 COYLE ST
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City | DETROIT
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State | MI
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Zip | 48227-2623
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Country | US
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Telephone | 313-624-5835
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Fax | 313-748-1028
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Provider Business Mailing Address
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Address Line | 33006 7 MILE RD SUITE #321
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City | LIVONIA
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State | MI
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Zip | 48152-1358
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Country | US
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Telephone | 313-624-5835
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Fax | 313-748-1028
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. ANTOINE TWUM MOORE
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Credential |
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Telephone | 818-339-2159
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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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