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General NPI Number Information
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NPI Number | 1881002822
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Entity Type | Organization
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Legal Business Name | HEAVENLLY HANDS HOME HEALTHCARE,LLC
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 4425 PORTSMOUTH BLVD SUITE 210 E
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City | CHESAPEAKE
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State | VA
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Zip | 23321-2152
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Country | US
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Telephone | 757-632-9454
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Fax |
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Provider Business Mailing Address
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Address Line | 4425 PORTSMOUTH BLVD SUITE 210 E
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City | CHESAPEAKE
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State | VA
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Zip | 23321-2152
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | LAUREN WILSON
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Credential |
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Telephone | 757-632-9454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | HCO-141137
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License Number State | VA
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