Provider Demographics
NPI:1285655001
Name:HEAVENS TOUCH NURSING SERVICES LLC
Entity type:Organization
Organization Name:HEAVENS TOUCH NURSING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LESHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:IVEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:804-377-6966
Mailing Address - Street 1:7124 FOREST HILL AVE STE C
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-1541
Mailing Address - Country:US
Mailing Address - Phone:804-377-6966
Mailing Address - Fax:804-726-6251
Practice Address - Street 1:7124 FOREST HILL AVE STE C
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-1541
Practice Address - Country:US
Practice Address - Phone:804-377-6966
Practice Address - Fax:804-726-6251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA497599251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010196892Medicaid
VA010050910OtherMEDICAID RESPITE NUMBER
VA010196892OtherSKILLED NURSING VISIT
VA010038049OtherHOME BASED AIDS SERVCES
VA010031435Medicaid
VA010050987OtherPRIVATE DUTY NURSING
VA010050995OtherEXPANDED PRENATAL&INFANT
VA010196892Medicaid