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General NPI Number Information
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NPI Number | 1558595173
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Entity Type | Organization
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Legal Business Name | HEAVENLY HANDS 4 YOU HOME HEALTH AGENCY, LLC
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 06/22/2009
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Provider Practice Location Address
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Address Line | 2644 LAKEVIEW AVE
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City | DAYTON
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State | OH
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Zip | 45408-1642
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Country | US
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Telephone | 937-732-4997
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Fax | 937-938-1508
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Provider Business Mailing Address
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Address Line | 2644 LAKEVIEW AVE
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City | DAYTON
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State | OH
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Zip | 45417-1908
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Country | US
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Telephone | 937-732-4997
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Fax | 937-938-1508
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. SHIMECA N BOOTH
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Credential | LPN, AHSM
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Telephone | 937-361-6012
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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 | OH
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