Heavenly Healthcare Agency, Inc.

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

HC2337 Issued in NC

Legal business name

HEAVENLY HEALTHCARE AGENCY, INC.

Practice address

503 W McGee St
Greensboro, NC 27401-2702

Phone

(336) 230-0808

Fax

(336) 230-0842

NPI assigned

Oct 13, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Antoinetta D Fulton

Title

Owner

Phone

(336) 230-0808

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Heavenly Healthcare Agency Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Heavenly Healthcare Agency Inc

  • Personal Care Attendant
  • Danville, VA
  • NPI 1912168568
  NPD tax ID

Locations

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326138397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 W MCGEE ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012702",
            "telephone_number": "336-230-0808",
            "fax_number": "336-230-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 W MCGEE ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012702",
            "telephone_number": "336-230-0808",
            "fax_number": "336-230-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY HEALTHCARE AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FULTON",
        "authorized_official_first_name": "ANTOINETTA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-230-0808",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": "NC",
            "license": "HC2337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600937",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409611",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Boedicker Heath, RN
• Spencer McKan Heath III
• Heavely Angels
• Heavenly Angels Group Home, Inc
• Heavenly Embrace (Mitchell Brown)
• Heavenlygates, Inc.
• Stephen Perry Hebard, LPC
• Donald Vincent Heck, MD
• Hecker Ophthalmology PA
• Kathryn J Hecker, MD

• Home Health Aide in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Home Health Aide in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.