34D2023272 CLIA NUMBER - HEAVENLY TOUCH CARE HOME

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Laboratory Demographics

CLIA Number: 34D2023272

Facility Name: HEAVENLY TOUCH CARE HOME

Facility Address:
429 CROCKER ROAD
KINGS MOUNTAIN, NC
ZIP 28086
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Facility Phone Number: 704 736-6429

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1083730055

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	34D2023272
LAB Type	Assisted Living Facility
Facility Name	HEAVENLY TOUCH CARE HOME
Street	429 CROCKER ROAD
City	KINGS MOUNTAIN
State	NC
ZIP	28086
Phone	704 736-6429
CertificateType	4
CertificateEffectiveDate	4/20/2023
CertificateExpirationDate	4/19/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024