Provider Demographics
NPI:1912559154
Name:HEAVENLY ANGEL CARE LLC
Entity Type:Organization
Organization Name:HEAVENLY ANGEL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEINI
Authorized Official - Middle Name:
Authorized Official - Last Name:TOKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-680-9371
Mailing Address - Street 1:119 KELLOGG AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-3537
Mailing Address - Country:US
Mailing Address - Phone:650-680-9371
Mailing Address - Fax:
Practice Address - Street 1:119 KELLOGG AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-3537
Practice Address - Country:US
Practice Address - Phone:650-680-9371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care