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General NPI Number Information
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NPI Number | 1659979425
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Entity Type | Organization
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Legal Business Name | HEAVENLY CARE INC
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Dates
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Enumeration Date | 10/14/2020
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Last Update Date | 10/16/2020
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Provider Practice Location Address
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Address Line | 117 EVENINGWIND DR
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City | MARION
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State | AR
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Zip | 72364-3017
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Country | US
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Telephone | 901-326-4851
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Fax |
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Provider Business Mailing Address
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Address Line | 117 EVENINGWIND DR
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City | MARION
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State | AR
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Zip | 72364-3017
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Country | US
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Telephone | 901-326-4851
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. GABRIELLE GUY
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Credential | RN
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Telephone | 901-326-4851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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