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General NPI Number Information
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NPI Number | 1700316965
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Entity Type | Organization
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Legal Business Name | HEAVEN CARES LLC
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 06/19/2017
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Provider Practice Location Address
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Address Line | 3920 S OLD HIGHWAY 94 STE 34
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City | SAINT CHARLES
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State | MO
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Zip | 63304-2835
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Country | US
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Telephone | 636-362-2200
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Fax | 636-362-2354
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Provider Business Mailing Address
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Address Line | 3920 S OLD HIGHWAY 94 STE 34
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City | SAINT CHARLES
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State | MO
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Zip | 63304-2835
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Country | US
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Telephone | 314-458-6779
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Fax | 636-362-2354
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MORNAY BROOKS KENNEDY
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Credential |
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Telephone | 636-362-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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