Provider Demographics
NPI:1508268871
Name:HEAVENLY STAFFING INC
Entity Type:Organization
Organization Name:HEAVENLY STAFFING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GISELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-848-4844
Mailing Address - Street 1:PO BOX 140443
Mailing Address - Street 2:STATION B
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-0443
Mailing Address - Country:US
Mailing Address - Phone:718-848-4844
Mailing Address - Fax:888-491-9606
Practice Address - Street 1:15615 76TH ST
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-2517
Practice Address - Country:US
Practice Address - Phone:718-848-4844
Practice Address - Fax:888-491-9606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health