Provider Demographics
NPI:1588800734
Name:HEAVEN'S COOP, INC
Entity Type:Organization
Organization Name:HEAVEN'S COOP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-492-0293
Mailing Address - Street 1:3010 MONROE RD STE 108D
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-7533
Mailing Address - Country:US
Mailing Address - Phone:704-492-0392
Mailing Address - Fax:
Practice Address - Street 1:3010 MONROE RD STE 108D
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-7533
Practice Address - Country:US
Practice Address - Phone:704-492-0392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management