Provider Demographics
NPI:1568765451
Name:HEAVENLY TOUCH HOME HEALTHCARE & STAFFING LLC
Entity Type:Organization
Organization Name:HEAVENLY TOUCH HOME HEALTHCARE & STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HILDRETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON-LEON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:757-201-1488
Mailing Address - Street 1:1334 HAFFORD RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-8670
Mailing Address - Country:US
Mailing Address - Phone:757-201-1488
Mailing Address - Fax:
Practice Address - Street 1:900 COMMONWEALTH PL
Practice Address - Street 2:SUITE 216
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4517
Practice Address - Country:US
Practice Address - Phone:757-217-9951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health