# HEAVENLY HAVEN CARE SERVICE

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

## Provider details

- **NPI number:** 1467760579
- **Authorized official:** DOROTHY NELSON (CEO)
- **Authorized official phone:** (225) 357-7206

## Contact information

- **Practice address:** 4824 E BROOKSTOWN DR, BATON ROUGE, LA 70805-3823
- **Practice address phone:** (225) 357-7206
- **Practice address fax:** (225) 357-6424
- **Mailing address:** 4824 E BROOKSTOWN DR, BATON ROUGE, LA 70805-3823
- **Mailing address phone:** (225) 357-7206
- **Mailing address fax:** (225) 357-6424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 20227 | LA | — |
| 251E00000X | Home Health Agency | 7258 | LA | — |
| 385H00000X | Respite Care | 13045 | LA | Yes |

## Other

- **Enumeration date:** 09/23/2010
- **Last updated:** 09/30/2010