Provider Demographics
NPI:1235917360
Name:M&E HEAVENLY CARE LLC
Entity Type:Organization
Organization Name:M&E HEAVENLY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:ELFIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSEUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-707-2374
Mailing Address - Street 1:1434 SW DOW LN
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-1631
Mailing Address - Country:US
Mailing Address - Phone:561-707-2374
Mailing Address - Fax:
Practice Address - Street 1:1434 SW DOW LN
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-1631
Practice Address - Country:US
Practice Address - Phone:561-707-2374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services