Provider Demographics
NPI:1558595173
Name:HEAVENLY HANDS 4 YOU HOME HEALTH AGENCY, LLC
Entity Type:Organization
Organization Name:HEAVENLY HANDS 4 YOU HOME HEALTH AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIMECA
Authorized Official - Middle Name:N
Authorized Official - Last Name:BOOTH
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, AHSM
Authorized Official - Phone:937-361-6012
Mailing Address - Street 1:2644 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-1908
Mailing Address - Country:US
Mailing Address - Phone:937-732-4997
Mailing Address - Fax:937-938-1508
Practice Address - Street 1:2644 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45408-1642
Practice Address - Country:US
Practice Address - Phone:937-732-4997
Practice Address - Fax:937-938-1508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health