Provider Demographics
NPI:1538503420
Name:HEAVENLY ANGELS HHC
Entity Type:Organization
Organization Name:HEAVENLY ANGELS HHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SKINNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-539-0216
Mailing Address - Street 1:174 E WASHINGTON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4536
Mailing Address - Country:US
Mailing Address - Phone:757-539-0216
Mailing Address - Fax:757-539-0217
Practice Address - Street 1:174 E WASHINGTON ST
Practice Address - Street 2:SUITE B
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4536
Practice Address - Country:US
Practice Address - Phone:757-539-0216
Practice Address - Fax:757-539-0217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-13925251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health