Organization
HEAVEN DIVINE ANGELS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AVONA MARIE GLAY (OWNER)
(703) 670-7075
Entity
Organization
Contact information
Practice address
4722 S PARK CT, WOODBRIDGE, VA 22193-3074
(703) 670-7075
Mailing address
4722 S PARK CT, WOODBRIDGE, VA 22193-3074
(703) 670-7075
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
09L19462
VA
Other
Enumeration date
04/30/2009
Last updated
04/30/2009
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