Provider Demographics
NPI:1740753839
Name:HEAVENLY HEARTS IN - HOME SERVICE LLC
Entity Type:Organization
Organization Name:HEAVENLY HEARTS IN - HOME SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-479-1860
Mailing Address - Street 1:4200 CHERRY WOOD TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-1627
Mailing Address - Country:US
Mailing Address - Phone:314-479-1860
Mailing Address - Fax:
Practice Address - Street 1:4200 CHERRY WOOD TRAIL DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-1627
Practice Address - Country:US
Practice Address - Phone:314-479-1860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health