# HEAVEN CARE NURSING AGENCY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HEAVEN CARE NURSING AGENCY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1700209624
- **Legal business name:** HEAVEN CARE NURSING AGENCY
- **Authorized official:** DOMINIQUE CHARLES-BOUTE (ADMINISTRATOR)
- **Authorized official phone:** (754) 400-0887

## Contact information

- **Practice address:** 20295 NW 2ND AVE, SUITE 301, MIAMI GARDENS, FL 33169-2550
- **Practice address phone:** (754) 400-0887
- **Mailing address:** 20295 NW 2ND AVE, SUITE 301, MIAMI GARDENS, FL 33169-2550
- **Mailing address phone:** (754) 400-0887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/29/2014
- **Last updated:** 01/29/2014