Provider Demographics
NPI:1154215762
Name:HEAVENLY CARE OF THE CAROLINAS LLC
Entity type:Organization
Organization Name:HEAVENLY CARE OF THE CAROLINAS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESEIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-414-9297
Mailing Address - Street 1:924 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-1653
Mailing Address - Country:US
Mailing Address - Phone:864-414-9297
Mailing Address - Fax:864-424-9142
Practice Address - Street 1:924 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-1653
Practice Address - Country:US
Practice Address - Phone:864-414-9297
Practice Address - Fax:864-424-9142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No385H00000XRespite Care FacilityRespite Care