Provider Demographics
NPI:1558921817
Name:HEAVENS WAY SERVICES INC
Entity Type:Organization
Organization Name:HEAVENS WAY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TCHUEMBUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-793-9840
Mailing Address - Street 1:9710 FIVE OAKS RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-1109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9710 FIVE OAKS RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-1109
Practice Address - Country:US
Practice Address - Phone:301-793-9840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities