Heavenly Living LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

HEAVENLY LIVING LLC

Practice address

21101 Deodora Dr
South Chesterfield, VA 23803-2224

Phone

(804) 481-0313

NPI assigned

Aug 3, 2020

Last updated

Aug 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Noel Kanga Sr.

Title

Executive Director/Owner

Phone

(804) 481-0313

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1902416191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21101 DEODORA DR",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "238032224",
            "telephone_number": "804-481-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21101 DEODORA DR",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "238032224",
            "telephone_number": "804-481-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "KANGA",
        "authorized_official_first_name": "NOEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/OWNER",
        "authorized_official_telephone_number": "804-481-0313",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in South Chesterfield, VA
• Providers in South Chesterfield, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.