Provider Demographics
NPI:1861847881
Name:HEAVENLY HANDS HOSPICE, LLC
Entity Type:Organization
Organization Name:HEAVENLY HANDS HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TELISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:770-990-5120
Mailing Address - Street 1:2759 DELK RD SE STE 2080
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8859
Mailing Address - Country:US
Mailing Address - Phone:770-485-9186
Mailing Address - Fax:770-672-7352
Practice Address - Street 1:2759 DELK RD SE STE 2080
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8859
Practice Address - Country:US
Practice Address - Phone:770-485-9186
Practice Address - Fax:770-672-7352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based