Provider Demographics
NPI:1609197581
Name:A HEAVENLY SONSHINE SERVICE CO
Entity Type:Organization
Organization Name:A HEAVENLY SONSHINE SERVICE CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GENTRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-207-0754
Mailing Address - Street 1:110 OLD GRAY STATION RD
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-3434
Mailing Address - Country:US
Mailing Address - Phone:423-207-0754
Mailing Address - Fax:423-207-0695
Practice Address - Street 1:110 OLD GRAY STATION RD
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:TN
Practice Address - Zip Code:37615-3434
Practice Address - Country:US
Practice Address - Phone:423-207-0754
Practice Address - Fax:423-207-0695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000013996253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care