NPIMap

Organization Active NPI

Heavenly Homecare Agency, LLC

  • In Home Supportive Care Agency
  • Randallstown, MD
National Provider Identifier
1942711726
Registry record updated Oct 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
HEAVENLY HOMECARE AGENCY, LLC
Practice address
3817 Cassandra Rd
Randallstown, MD 21133-3322
Phone
(347) 998-2976
Fax
(410) 630-5024
NPI assigned
Oct 19, 2017
Last updated
Oct 19, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2017

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

Authorized official

Name
Donnette K Lee
Title
Owner
Phone
(347) 998-2976

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

3817 Cassandra Rd
Randallstown, MD 21133-3322

Mailing address

3817 Cassandra Rd
Randallstown, MD 21133-3322
Phone (347) 998-2976

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508371200000",
    "number": "1942711726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3817 CASSANDRA RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211333322",
            "telephone_number": "347-998-2976",
            "fax_number": "410-630-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3817 CASSANDRA RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211333322",
            "telephone_number": "347-998-2976",
            "fax_number": "410-630-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY HOMECARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-19",
        "last_updated": "2017-10-19",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DONNETTE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-998-2976"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.