# HEAVENLY HOME HEALTH, INC.

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

## Provider details

- **NPI number:** 1477799021
- **Authorized official:** MR. GERARDO B. SANTILLAN R.N. (CEO/PRESIDENT)
- **Authorized official phone:** (818) 500-9007

## Contact information

- **Practice address:** 805 E BROADWAY STE H, GLENDALE, CA 91205-4539
- **Practice address phone:** (818) 500-9007
- **Practice address fax:** (818) 500-9052
- **Mailing address:** 805 E BROADWAY STE H, GLENDALE, CA 91205-4539
- **Mailing address phone:** (818) 500-9007
- **Mailing address fax:** (818) 500-9052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 550001026 | CA | Yes |

## Other

- **Enumeration date:** 01/04/2009
- **Last updated:** 04/29/2013