Organization
HEAVENLY HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAYINEABEBA ASSEFA (CEO)
(703) 589-4408
Entity
Organization
Contact information
Practice address
44812 RUTHRON ST, LANCASTER, CA 93536-8413
(704) 589-4408
Mailing address
44812 RUTHRON ST, LANCASTER, CA 93536-8413
(704) 589-4408
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
194700400
CA
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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