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Organization
A HEAVENLY HOME HEALTHCARE AGENCY
Active
Organization
A HEAVENLY HOME HEALTHCARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE KIMBERLY STARKS B.S. (OWNER)
(614) 917-9118
Entity
Organization
Contact information
Practice address
430 COURTRIGHT DR, PICKERINGTON, OH 43147-1528
(614) 917-9118
Mailing address
430 COURTRIGHT DR, PICKERINGTON, OH 43147-1528
(614) 917-9118
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2531906
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2531906
ODMRDD CONTRACT NUMBER
OH
01
—
2743188
ODJFS MEDICAID PROVIDER #
OH
Enumeration date
08/10/2007
Last updated
09/07/2007
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