Provider Demographics
NPI:1316710049
Name:HEAVENLY HEARTS HOME CARE,LLC
Entity type:Organization
Organization Name:HEAVENLY HEARTS HOME CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:VERRET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-967-2331
Mailing Address - Street 1:11435 QUINT PL
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-8492
Mailing Address - Country:US
Mailing Address - Phone:228-967-2331
Mailing Address - Fax:
Practice Address - Street 1:11435 QUINT PL
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-8492
Practice Address - Country:US
Practice Address - Phone:228-967-2331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company