NPIMap

Organization Active NPI

Heavenly Hands Healthcare LLC

  • In Home Supportive Care Agency
  • Overland, MO
National Provider Identifier
1255070918
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
HEAVENLY HANDS HEALTHCARE LLC
Practice address
1614 Page Industrial Blvd
Apt a
Overland, MO 63123
Phone
(314) 896-3713
NPI assigned
Jun 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Authorized official

Name
Takesha Sharice GatesNPI 1811505712
Title
Ceo &Founder
Phone
(314) 896-3713

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X Primary
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

1614 Page Industrial Blvd
Apt a
Overland, MO 63123

Mailing address

561 Kingsland Ave Unit 300115
Saint Louis, MO 63130-5005
Phone (314) 896-3713

Other identifiers 1

IdentifierTypeStateIssuer
1811505712OtherMOPRIVATE PAY

Other names 1

  • Heavenly Hands Healthcare LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

561 Kingsland Ave
Unit 300115
Saint Louis, MO 63130

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1255070918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 KINGSLAND AVE UNIT 300115",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631305005",
            "telephone_number": "314-896-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 PAGE INDUSTRIAL BLVD",
            "address_2": "APT A",
            "city": "OVERLAND",
            "state": "MO",
            "postal_code": "63123",
            "telephone_number": "314-896-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY HANDS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "TAKESHA",
        "authorized_official_middle_name": "SHARICE",
        "authorized_official_title_or_position": "CEO &FOUNDER",
        "authorized_official_telephone_number": "314-896-3713"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PAY",
            "identifier": "1811505712",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heavenly Hands Healthcare LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Overland, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.