Provider Demographics
NPI:1821356890
Name:HEAVEN SENT HOME HEALTH SERVICES,LLC
Entity Type:Organization
Organization Name:HEAVEN SENT HOME HEALTH SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-357-6857
Mailing Address - Street 1:235 W ROOSEVELT AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-2640
Mailing Address - Country:US
Mailing Address - Phone:229-436-3070
Mailing Address - Fax:229-436-0406
Practice Address - Street 1:235 W ROOSEVELT AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-2640
Practice Address - Country:US
Practice Address - Phone:229-436-3070
Practice Address - Fax:229-436-0406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047-R-0034253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care