Provider Demographics
NPI:1912696352
Name:SHARDAE'S HEAVENLY TOUCH, LLC
Entity Type:Organization
Organization Name:SHARDAE'S HEAVENLY TOUCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-359-1845
Mailing Address - Street 1:4884 LA VENTANA TER
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-3443
Mailing Address - Country:US
Mailing Address - Phone:251-359-1845
Mailing Address - Fax:
Practice Address - Street 1:4884 LA VENTANA TER
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-3443
Practice Address - Country:US
Practice Address - Phone:251-359-1845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care