Provider Demographics
NPI:1750491791
Name:SHEILA ISAAC
Entity Type:Organization
Organization Name:SHEILA ISAAC
Other - Org Name:HEAVENLY CARE COMMUNITY HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:F
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-758-9886
Mailing Address - Street 1:409 S MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-7432
Mailing Address - Country:US
Mailing Address - Phone:903-758-9886
Mailing Address - Fax:903-234-0068
Practice Address - Street 1:409 S MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-7432
Practice Address - Country:US
Practice Address - Phone:903-758-9886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2007-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87Y/0000HO87Y320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities