Heavenlyhomes2008

Primary specialty

Home Delivered MealsTaxonomy code 332U00000X

License

S53046573199 Issued in IL

Legal business name

HEAVENLYHOMES2008

Practice address

15917 Drexel Ave
South Holland, IL 60473-1637

Phone

(708) 527-8338

Fax

(708) 331-5654

NPI assigned

Jun 5, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Smith

Title

Owner

Phone

(708) 527-8338

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1023277985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15917 DREXEL AVE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731637",
            "telephone_number": "708-527-8338",
            "fax_number": "708-331-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15917 DREXEL AVE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731637",
            "telephone_number": "708-527-8338",
            "fax_number": "708-331-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLYHOMES2008",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-527-8338"
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": "IL",
            "license": "S53046573199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Crystal Henderson
• Dionne Nicole Henderson, DDS
• Howard Julian Henry, MSW
• Stephanie Henry
• Leslie Hines

• Home Delivered Meals in South Holland, IL
• Providers in South Holland, IL by specialty
• Home Delivered Meals in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.