# HEAVENLY LIFE HOMECARE LLC

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

## Provider details

- **NPI number:** 1649863358
- **Authorized official:** ANITA OCRAN (ADMINISTRATOR)
- **Authorized official phone:** (678) 789-3320

## Contact information

- **Practice address:** 591 WILLIE KATE LANE, LAWRENCEVILLE, GA 30045
- **Practice address phone:** (678) 789-3320
- **Mailing address:** 591 WILLIE KATE LANE, LAWRENCEVILLE, GA 30045

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |

## Other

- **Enumeration date:** 02/12/2021
- **Last updated:** 02/16/2024