Provider Demographics
NPI:1619712494
Name:HEAVIN HELPS LLC
Entity type:Organization
Organization Name:HEAVIN HELPS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:HEAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:CHW
Authorized Official - Phone:831-901-1328
Mailing Address - Street 1:1560 VALLEY VIEW RD APT 18
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-5850
Mailing Address - Country:US
Mailing Address - Phone:831-901-1328
Mailing Address - Fax:
Practice Address - Street 1:1560 VALLEY VIEW RD APT 18
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5850
Practice Address - Country:US
Practice Address - Phone:831-901-1328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty