Organization
HEAVENLY HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOROTHY I NELSON (CEO)
(225) 357-7206
Entity
Organization
Contact information
Practice address
4824 E BROOKSTOWN DR, BATON ROUGE, LA 70805-3823
(225) 357-7206
(225) 357-6424
Mailing address
4824 E BROOKSTOWN DR, BATON ROUGE, LA 70805-3823
(225) 357-7206
(225) 357-6424
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
LA
Enumeration date
04/03/2008
Last updated
04/03/2008
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