Provider Demographics
NPI:1437301157
Name:HEAVEN AT HOME, INC.
Entity Type:Organization
Organization Name:HEAVEN AT HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:VANDERHOEF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-380-0500
Mailing Address - Street 1:PO BOX 51455
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76206-1455
Mailing Address - Country:US
Mailing Address - Phone:940-380-0500
Mailing Address - Fax:
Practice Address - Street 1:623 LONDONDERRY LN
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-7792
Practice Address - Country:US
Practice Address - Phone:940-380-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-13
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008072253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care