Organization
HEAVEN'S ANGELS HEALTH CARE SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAPHIDIEN LUCENA DAWIS (ADMINISTRATOR/PRESIDENT)
(847) 679-7682
Entity
Organization
Contact information
Practice address
7366 N LINCOLN AVE, SUITE 202, LINCOLNWOOD, IL 60712-1708
(847) 679-7682
(847) 679-7685
Mailing address
7366 N LINCOLN AVE, SUITE 202, LINCOLNWOOD, IL 60712-1708
(847) 679-7682
(847) 679-7685
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1010563
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1010563
STATE LICENSE
IL
Enumeration date
10/01/2006
Last updated
01/25/2013
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