Provider Demographics
NPI:1356189963
Name:HEAVEN ANGEL HOMEHEALTH LLC
Entity type:Organization
Organization Name:HEAVEN ANGEL HOMEHEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHARA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-234-8497
Mailing Address - Street 1:1420 NORTHBROOK DR STE 116
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-3870
Mailing Address - Country:US
Mailing Address - Phone:205-234-8497
Mailing Address - Fax:
Practice Address - Street 1:1420 NORTHBROOK DR STE 116
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-3870
Practice Address - Country:US
Practice Address - Phone:205-234-8497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty