Organization Active NPI

Heaven-on-Earth Network of Mamou, LLC

Adult Companion
Mamou, LA

National Provider Identifier

1184851453

Registry record updated Feb 17, 2025

On this page

Key facts
NPPES NPI Registry
National Provider Directory
NPI Registry JSON
Other providers in Mamou, LA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Adult CompanionTaxonomy code 372600000X
Legal business name: HEAVEN-ON-EARTH NETWORK OF MAMOU, LLC
Practice address: 1321 4TH Street
Mamou, LA 70554
Phone: (337) 468-2730
Fax: (337) 468-2782
NPI assigned: Jun 15, 2009
Last updated: Feb 17, 2025By the provider in NPPES
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Authorized official

Name: Mr. Myron Cordell Guillory
Title: Owner
Phone: (434) 229-4962

Specialties & licenses 6

Specialty (taxonomy)	Code	License	State	Primary
Chore Provider	372500000X
Adult Companion	372600000X			Primary
Attendant Care Provider	3747A0650X
Personal Care Attendant	3747P1801X
In Home Supportive Care Agency	253Z00000X	20161	LA
In Home Supportive Care Agency	253Z00000X	15227	LA

Addresses

Primary practice location

1321 4TH Street
Mamou, LA 70554

Mailing address

1321 4TH Street
Mamou, LA 70554
Phone (337) 468-2730

Other identifiers 7

Identifier	Type	State
1882691	Medicaid	LA
1435121	Medicaid	LA
2544977	Medicaid	LA
1882704	Medicaid	LA
1171336	Medicaid	LA
1882712	Medicaid	LA
1460893	Medicaid	LA

Other names 1

Heaven-On-Earth Network, Inc. Former legal business name

National Provider Directory

Tax ID family: Heaven-on-Earth Network Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Heaven-on-Earth Network, Inc.
- Personal Care Attendant
- Lake Charles, LA
- NPI 1114089356
NPD tax ID
Heaven-on-Earth Network, Inc.
- Personal Care Attendant
- Lake Charles, LA
- NPI 1205998440
NPD tax ID
Heaven-on-Earth Network, Inc.
- Personal Care Attendant
- Lake Charles, LA
- NPI 1215003397
NPD tax ID

NPI Registry JSON

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1184851453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 4TH STREET",
            "city": "MAMOU",
            "state": "LA",
            "postal_code": "70554",
            "telephone_number": "337-468-2730",
            "fax_number": "337-468-2782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 4TH STREET",
            "city": "MAMOU",
            "state": "LA",
            "postal_code": "70554",
            "telephone_number": "337-468-2730",
            "fax_number": "337-468-2782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVEN-ON-EARTH NETWORK OF MAMOU, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-15",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "GUILLORY",
        "authorized_official_first_name": "MYRON",
        "authorized_official_middle_name": "CORDELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-229-4962",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "LA",
            "license": "20161",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "LA",
            "license": "15227",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1882691",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1435121",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2544977",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1882704",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1171336",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1882712",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1460893",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heaven-On-Earth Network, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mamou, LA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.