Provider Demographics
NPI:1699442939
Name:HEAVENLY ANGEL HOSPICE LLC
Entity type:Organization
Organization Name:HEAVENLY ANGEL HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIELDEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BONSALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-263-7024
Mailing Address - Street 1:6991 E CAMELBACK RD STE D300
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-2492
Mailing Address - Country:US
Mailing Address - Phone:818-263-7024
Mailing Address - Fax:
Practice Address - Street 1:6991 E CAMELBACK RD STE D300
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2492
Practice Address - Country:US
Practice Address - Phone:818-263-7024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based