Provider Demographics
NPI:1396981932
Name:HEAVENLY HELPERS LIAISONS
Entity type:Organization
Organization Name:HEAVENLY HELPERS LIAISONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAVELL
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:DANIELSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:817-680-6370
Mailing Address - Street 1:113 WILDWOOD CT
Mailing Address - Street 2:APT C
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3289
Mailing Address - Country:US
Mailing Address - Phone:817-680-6370
Mailing Address - Fax:
Practice Address - Street 1:113 WILDWOOD CT
Practice Address - Street 2:APT C
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3289
Practice Address - Country:US
Practice Address - Phone:817-680-6370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-04
Last Update Date:2009-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health