Provider Demographics
NPI:1528649092
Name:HEAVENLY CARES HOME HEALTHCARE
Entity type:Organization
Organization Name:HEAVENLY CARES HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:NYOKIE
Authorized Official - Middle Name:I
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-599-2028
Mailing Address - Street 1:7959 COTTAGE HILL RD APT 1311
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-4163
Mailing Address - Country:US
Mailing Address - Phone:251-599-2028
Mailing Address - Fax:
Practice Address - Street 1:7959 COTTAGE HILL RD APT 1311
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-4163
Practice Address - Country:US
Practice Address - Phone:251-599-2028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health