Provider Demographics
NPI:1508410648
Name:HEAVEN SENT ADULT DAYCARE CENTER
Entity type:Organization
Organization Name:HEAVEN SENT ADULT DAYCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:DANETTE
Authorized Official - Last Name:WALLS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:501-313-2961
Mailing Address - Street 1:5 INNWOOD CIR STE 110
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-2499
Mailing Address - Country:US
Mailing Address - Phone:501-313-2961
Mailing Address - Fax:501-904-2196
Practice Address - Street 1:5 INNWOOD CIR STE 110
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-2499
Practice Address - Country:US
Practice Address - Phone:501-313-2961
Practice Address - Fax:501-904-2196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-26
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Single Specialty