Heavenly Care LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

HEAVENLY CARE LLC

Practice address

3129 W Acapulco LN
Phoenix, AZ 85053-4885

Phone

(601) 316-1347

NPI assigned

May 24, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Kanobayita Doris

Title

Ceo

Phone

(601) 316-1347

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Heavenly Care LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Heavenly Care LLC

  • Behavior Technician
  • Phoenix, AZ
  • NPI 1497320386
  NPD tax ID
• Heavenly Care LLC

  • Community/Behavioral Health Agency
  • Glendale, AZ
  • NPI 1962193938
  NPD tax ID

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1750956744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3129 W ACAPULCO LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850534885",
            "telephone_number": "601-316-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3129 W ACAPULCO LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850534885",
            "telephone_number": "601-316-1347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-24",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "DORIS",
        "authorized_official_first_name": "KANOBAYITA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-316-1347",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092973",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David A. Heaton, M.D.
• Heaven N Soul Hospice Inc
• Heavenly Angels Care Home LLC
• Heavenly Behavioral Homes LLC
• Heavenly Care LLC
• Heavenly Hospice LLC
• Michelle Elizabeth Hebard
• Matthew Olding Hebb, M.D., PH.D.
• Sheila Hebers, PHD., LCSW
• Stephanie Kristen Hebert, PHARM.D.

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.