Provider Demographics
NPI:1427397447
Name:HEAVENLY CHOICE HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:HEAVENLY CHOICE HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CALIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-607-0963
Mailing Address - Street 1:4019 STAHL RD
Mailing Address - Street 2:STE 106
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-1669
Mailing Address - Country:US
Mailing Address - Phone:210-607-0963
Mailing Address - Fax:
Practice Address - Street 1:4019 STAHL RD
Practice Address - Street 2:STE 106
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-1669
Practice Address - Country:US
Practice Address - Phone:210-607-0963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health