Provider Demographics
NPI:1881628337
Name:HEAVENLY HEALTH CARE, LLC
Entity type:Organization
Organization Name:HEAVENLY HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GRECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-271-4755
Mailing Address - Street 1:1506 E GRIFFIN PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2426
Mailing Address - Country:US
Mailing Address - Phone:956-271-4755
Mailing Address - Fax:956-598-5098
Practice Address - Street 1:1506 E GRIFFIN PKWY STE B
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2426
Practice Address - Country:US
Practice Address - Phone:956-271-4755
Practice Address - Fax:956-598-5098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
TX010551251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208647201Medicaid
TX010551OtherTDADS
TX001018475OtherPAS