Provider Demographics
NPI:1992844559
Name:HEAVEN'S TOUCH HOME CARE SERVICES
Entity Type:Organization
Organization Name:HEAVEN'S TOUCH HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SKINNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1252-522-5984
Mailing Address - Street 1:PO BOX 2023
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28502-2023
Mailing Address - Country:US
Mailing Address - Phone:252-522-5984
Mailing Address - Fax:252-527-9854
Practice Address - Street 1:327 ALEXANDER ROUSE RD
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-7006
Practice Address - Country:US
Practice Address - Phone:252-522-5984
Practice Address - Fax:252-527-9854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC 24573747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601024Medicaid