MEDICARE: HEAVENS CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1225609365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAVENS CARE LLC

Provider Business Mailing Address
First Line	:	341 FERNWOOD DR.
Second Line	:	HOUSE
City	:	AKRON
State	:	OH
Zip	:	44320
Country	:	US
Telephone Number	:	330-227-8367
Fax Number	:

Provider Business Practice Location Address
First Line	:	341 FERNWOOD DR.
Second Line	:	HOUSE
City	:	AKRON
State	:	OH
Zip	:	44320-4432
Country	:	US
Telephone Number	:	330-227-3927
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	EBONI ONEIL
Credential	:
Telephone Number	:	330-227-8367

Provider Enumeration Date	:	07/09/2021
Last Update Date	:	07/09/2021

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