HEAVENLY CARE LLC NPI 1750956744

NPI Information

NPI: 1750956744
Provider Name: HEAVENLY CARE LLC
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
3129 W ACAPULCO LN
PHOENIX, AZ
ZIP 85053
Phone: (601) 316-1347
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HEAVENLY CARE LLC is a residential treatment facility, intellectual and/or developmental disabilities in Phoenix, AZ. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. HEAVENLY CARE LLC NPI is 1750956744. The provider is registered as an organization entity type.

The provider's business location address is:

3129 W ACAPULCO LN
PHOENIX, AZ
ZIP 85053-885
Phone: (601) 316-1347

The provider's authorized official is Kanobayita Doris .
The authorized official title is Ceo and has the following contact phone number (601) 316-1347.

The enumeration date for this NPI number is 5/24/2021 and was last updated on 2/28/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	092973	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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