Provider Demographics
NPI:1881100980
Name:A TOUCH OF HEAVEN, INC
Entity type:Organization
Organization Name:A TOUCH OF HEAVEN, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGOT
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-816-9894
Mailing Address - Street 1:2352 AZALEA GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23513-3910
Mailing Address - Country:US
Mailing Address - Phone:757-816-9894
Mailing Address - Fax:757-214-6634
Practice Address - Street 1:4616 E PRINCESS ANNE RD UNIT C
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-1676
Practice Address - Country:US
Practice Address - Phone:757-816-9894
Practice Address - Fax:757-214-6634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-27
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1881100980Medicaid