MEDICARE: HEAVENLY HOME CARE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	174200000X	Meals Provider
2	251E00000X	Home Health Agency
3	3747P1801X	Personal Care Attendant
4	385H00000X	Respite Care

General Provider Information

NPI Number	:	1437083953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAVENLY HOME CARE

Provider Business Mailing Address
First Line	:	4412 HAGEN AVE
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34608-3511
Country	:	US
Telephone Number	:	352-740-5482
Fax Number	:

Provider Business Practice Location Address
First Line	:	4412 HAGEN AVE
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34608-3511
Country	:	US
Telephone Number	:	352-740-5482
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TONIETTE LEANN ADAMS
Credential	:	ADAMS
Telephone Number	:	352-740-5482

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “HEAVENLY HOME CARE ” Practice Location

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