Heavenly Arms LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

88301613B Issued in NC

Legal business name

HEAVENLY ARMS LLC

Practice address

2470 Emerald PL
Suite D
Greenville, NC 27834-5786

Phone

(252) 752-3211

Fax

(252) 752-3211

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Daniel Gabriel Moore

Title

Ceo

Phone

(252) 752-3211

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1437246345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2470 EMERALD PL",
            "address_2": "SUITE D",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345786",
            "telephone_number": "252-752-3211",
            "fax_number": "252-752-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 EMERALD PL",
            "address_2": "SUITE D",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345786",
            "telephone_number": "252-752-3211",
            "fax_number": "252-752-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY ARMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "GABRIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-752-3211"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-074-164",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "88301613B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301613G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DFS LICENSE NUMBER",
            "identifier": "MHL-074-164",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8601613B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Heath, PT
• Karmen Heath
• Kathy C Heath, MS-CCC, SLP
• Samuel R Heath Jr., PHD
• Heaven Cares L.L.C
• Heavenly Hands Home Care Inc
• Cory Anthony Heavner
• Barbara Hebert, MA, LMFT
• Colin Charles Hebert, M.D.
• Ahmed Abdalla Reda Hebishy, MD

• Mental Illness Community Based Residential Treatment Facility in Greenville, NC
• Providers in Greenville, NC by specialty
• Mental Illness Community Based Residential Treatment Facility in North Carolina

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