Provider Demographics
NPI:1952092496
Name:HEAVENLY HANDS COMMUNITY HELP GROUP, LLC
Entity type:Organization
Organization Name:HEAVENLY HANDS COMMUNITY HELP GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JATIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SYLVESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-801-2011
Mailing Address - Street 1:2000 TOWN CTR STE 1900
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-1152
Mailing Address - Country:US
Mailing Address - Phone:248-801-2011
Mailing Address - Fax:
Practice Address - Street 1:2000 TOWN CTR STE 1900
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-1152
Practice Address - Country:US
Practice Address - Phone:248-801-2011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1245985993Medicaid