# HEAVENLY PLACE LLC

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

## Provider details

- **NPI number:** 1356783229
- **Authorized official:** JULIET OKWOSHAH (ADMINISTRATOR)
- **Authorized official phone:** (919) 819-3882

## Contact information

- **Practice address:** 8600 NEUSE HUNTER DR, RALEIGH, NC 27616-7735
- **Practice address phone:** (919) 819-3882
- **Mailing address:** PO BOX 41153, RALEIGH, NC 27629-1153

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL-092-866 | NC | Yes |

## Other

- **Enumeration date:** 07/21/2013
- **Last updated:** 07/21/2013