Heaven Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

HEAVEN CARE LLC

Practice address

4316 Summercrest Blvd
Antioch, TN 37013-5805

Phone

(615) 779-1511

NPI assigned

Oct 20, 2022

Organization subpart

No

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

Authorized official

Name

Genet Hailu

Title

President

Phone

(615) 779-1511

Specialties & licenses 1

Addresses

Other names 1

• Heaven Care LLC Doing business as

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1457078453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4316 SUMMERCREST BLVD",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370135805",
            "telephone_number": "615-779-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4316 SUMMERCREST BLVD",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370135805",
            "telephone_number": "615-779-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVEN CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-20",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "HAILU",
        "authorized_official_first_name": "GENET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-779-1511"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heaven Care LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heaven Care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Antioch, TN
• Providers in Antioch, TN by specialty
• In Home Supportive Care Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.