MEDICARE: HEAVENLY TOUCH HOME CARE SERVICE,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	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598150062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAVENLY TOUCH HOME CARE SERVICE,LLC

Provider Business Mailing Address
First Line	:	1248 MELBOURNE RD
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-4137
Country	:	US
Telephone Number	:	216-324-6342
Fax Number	:

Provider Business Practice Location Address
First Line	:	1248 MELBOURNE RD
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-4137
Country	:	US
Telephone Number	:	216-324-6342
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISS DAWN LA'TOYA WRIGHT
Credential	:
Telephone Number	:	216-324-6342

Provider Enumeration Date	:	04/01/2015
Last Update Date	:	04/01/2015

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