Provider Demographics
NPI:1821278763
Name:HEAVEN SENT HOME HEALTH CARE
Entity Type:Organization
Organization Name:HEAVEN SENT HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:LACRESSIA
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:NURSING ASS
Authorized Official - Phone:205-970-6162
Mailing Address - Street 1:1 PERIMETER PARK S STE 100N
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3248
Mailing Address - Country:US
Mailing Address - Phone:205-970-6162
Mailing Address - Fax:205-970-6238
Practice Address - Street 1:1 PERIMETER PARK S STE 100N
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3248
Practice Address - Country:US
Practice Address - Phone:205-970-6162
Practice Address - Fax:205-970-6238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health