# HEAVEN DIVINE ANGELS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144464462
- **Authorized official:** MS. AVONA MARIE GLAY (OWNER)
- **Authorized official phone:** (703) 670-7075

## Contact information

- **Practice address:** 4722 S PARK CT, WOODBRIDGE, VA 22193-3074
- **Practice address phone:** (703) 670-7075
- **Mailing address:** 4722 S PARK CT, WOODBRIDGE, VA 22193-3074
- **Mailing address phone:** (703) 670-7075

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 09L19462 | VA | Yes |

## Other

- **Enumeration date:** 04/30/2009
- **Last updated:** 04/30/2009