Provider Demographics
NPI:1710356332
Name:HEAVENLY ANGELS HOMEMAKER & COMPANION SERVICES
Entity Type:Organization
Organization Name:HEAVENLY ANGELS HOMEMAKER & COMPANION SERVICES
Other - Org Name:ALWAYS FAMILY HOME HEALTH CARE, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:904-444-5581
Mailing Address - Street 1:9695 WATERSHED DR S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32220-0903
Mailing Address - Country:US
Mailing Address - Phone:904-444-5581
Mailing Address - Fax:
Practice Address - Street 1:9695 WATERSHED DR S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32220-0903
Practice Address - Country:US
Practice Address - Phone:904-444-5581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care