Provider Demographics
NPI:1790180024
Name:HEAVEN'S BLANKET LLC
Entity Type:Organization
Organization Name:HEAVEN'S BLANKET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATRECE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-995-7917
Mailing Address - Street 1:18302 COUNTY ROAD 40
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-7312
Mailing Address - Country:US
Mailing Address - Phone:281-995-7917
Mailing Address - Fax:
Practice Address - Street 1:18302 COUNTY ROAD 40
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-7312
Practice Address - Country:US
Practice Address - Phone:281-995-7917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-29
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities