Organization
HEAVENLY HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOROTHY M NESLON (CEO)
(225) 357-7206
Entity
Organization
Contact information
Practice address
4824 E BROOKSTOWN DR, BATON ROUGE, LA 70805-3823
(225) 357-7206
Mailing address
4824 E BROOKSTOWN DR, BATON ROUGE, LA 70805-3823
(225) 357-7206
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
7258
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174432
PCS
LA
Enumeration date
03/01/2007
Last updated
03/14/2008
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