# HEAVENLY ANGELS HOME CARE

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

## Provider details

- **NPI number:** 1679875710
- **Authorized official:** MS. JENNIFER LYNN DE LOS REYES (OWNER-PRESIDENT)
- **Authorized official phone:** (858) 444-7094

## Contact information

- **Practice address:** 4709 MOUNT ABERNATHY AVE, SAN DIEGO, CA 92117-3340
- **Practice address phone:** (858) 444-7904
- **Practice address fax:** (858) 278-2093
- **Mailing address:** 4709 MOUNT ABERNATHY AVE, SAN DIEGO, CA 92117-3340
- **Mailing address phone:** (858) 444-7904
- **Mailing address fax:** (858) 278-2093

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | B2010022157 | CA | — |
| 251E00000X | Home Health Agency | B2010022157 | CA | Yes |
| 251J00000X | Nursing Care Agency | B2010022157 | CA | — |
| 253Z00000X | In Home Supportive Care Agency | B2010022157 | CA | — |

## Other

- **Enumeration date:** 11/22/2010
- **Last updated:** 11/22/2010