Provider Demographics
NPI:1962209601
Name:HEAVENLY GRACE HOME CARE, LLC
Entity type:Organization
Organization Name:HEAVENLY GRACE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LVN/ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MELINDA
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:361-209-3474
Mailing Address - Street 1:PO BOX 937
Mailing Address - Street 2:
Mailing Address - City:FALFURRIAS
Mailing Address - State:TX
Mailing Address - Zip Code:78355-0937
Mailing Address - Country:US
Mailing Address - Phone:361-279-9307
Mailing Address - Fax:361-502-4424
Practice Address - Street 1:219 E RICE ST STE 1&2
Practice Address - Street 2:
Practice Address - City:FALFURRIAS
Practice Address - State:TX
Practice Address - Zip Code:78355-3621
Practice Address - Country:US
Practice Address - Phone:361-279-9307
Practice Address - Fax:361-502-4424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-28
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care