Provider Demographics
NPI:1427314384
Name:HEAVEN SENT CAREGIVERS
Entity type:Organization
Organization Name:HEAVEN SENT CAREGIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DORSHEKA
Authorized Official - Middle Name:JAVARA
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-777-1928
Mailing Address - Street 1:2317 BOOKER AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-4904
Mailing Address - Country:US
Mailing Address - Phone:704-777-1928
Mailing Address - Fax:
Practice Address - Street 1:1801 N TRYON ST
Practice Address - Street 2:SUITE B211
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-2704
Practice Address - Country:US
Practice Address - Phone:704-777-1928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4536253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care