Provider Demographics
NPI:1821706516
Name:HEAVENLY LOVE HOMECARE LLC
Entity Type:Organization
Organization Name:HEAVENLY LOVE HOMECARE LLC
Other - Org Name:HEAVENLY LOVE HOMECARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-355-8288
Mailing Address - Street 1:8035 E R L THORNTON FWY STE 260
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-0002
Mailing Address - Country:US
Mailing Address - Phone:214-355-8882
Mailing Address - Fax:
Practice Address - Street 1:8035 E R L THORNTON FWY STE 260
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-0002
Practice Address - Country:US
Practice Address - Phone:214-355-8882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care