Provider Demographics
NPI:1194401364
Name:HEAVENS HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:HEAVENS HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BONITA
Authorized Official - Middle Name:C
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-912-1174
Mailing Address - Street 1:675 ALPHA DRIVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143
Mailing Address - Country:US
Mailing Address - Phone:216-912-1174
Mailing Address - Fax:216-675-0026
Practice Address - Street 1:675 ALPHA DRIVE
Practice Address - Street 2:SUITE G
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143
Practice Address - Country:US
Practice Address - Phone:216-912-1174
Practice Address - Fax:216-675-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care