Provider Demographics
NPI:1821757394
Name:HEAVENLY TRIUMPH HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:HEAVENLY TRIUMPH HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:JEUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-278-4303
Mailing Address - Street 1:3646 HUDSON LN
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-8551
Mailing Address - Country:US
Mailing Address - Phone:786-278-4303
Mailing Address - Fax:
Practice Address - Street 1:3646 HUDSON LN
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-8551
Practice Address - Country:US
Practice Address - Phone:786-278-4303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services