A Heavenly Home, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

A HEAVENLY HOME, LLC

Practice address

1920 Prospect Ave
Paso Robles, CA 93446-6343

Phone

(310) 889-8586

Fax

(805) 296-3239

NPI assigned

Jun 25, 2019

Last updated

Jun 25, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Rodrigues Jimenez

Title

Owner

Phone

(310) 889-8586

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1104487784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 PROSPECT AVE",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934466343",
            "telephone_number": "310-889-8586",
            "fax_number": "805-296-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 PROSPECT AVE",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934466343",
            "telephone_number": "310-889-8586",
            "fax_number": "805-296-3239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A HEAVENLY HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "RODRIGUES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-889-8586",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Paso Robles, CA
• Providers in Paso Robles, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.