Provider Demographics
NPI:1497089221
Name:HEAVEN SENT SERVICES, L.L.C.
Entity Type:Organization
Organization Name:HEAVEN SENT SERVICES, L.L.C.
Other - Org Name:HEAVENLY CARE PHC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DALYLA
Authorized Official - Middle Name:IRIS
Authorized Official - Last Name:JASSO-DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-720-4490
Mailing Address - Street 1:4842 S JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6569
Mailing Address - Country:US
Mailing Address - Phone:956-720-4490
Mailing Address - Fax:956-720-4402
Practice Address - Street 1:4842 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6569
Practice Address - Country:US
Practice Address - Phone:956-720-4490
Practice Address - Fax:956-720-4402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-26
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
TX0130563747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001019344OtherDADS CONTRACTS
TX220154301Medicaid