Provider Demographics
NPI:1487023602
Name:HEAVENLY HEARTS SERVICES LLC
Entity Type:Organization
Organization Name:HEAVENLY HEARTS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-525-8945
Mailing Address - Street 1:2565 N TOLEDO BLADE BLVD
Mailing Address - Street 2:UNIT 1
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34289-9306
Mailing Address - Country:US
Mailing Address - Phone:941-525-8945
Mailing Address - Fax:
Practice Address - Street 1:2565 N TOLEDO BLADE BLVD
Practice Address - Street 2:UNIT 1
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34289-9306
Practice Address - Country:US
Practice Address - Phone:941-525-8945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL232623253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care