Organization
HEAVENLY HOME HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDERICK LEON JENKINS (OWNER)
(757) 944-0096
Entity
Organization
Contact information
Practice address
707 GITTINGS ST, SUITE 130, SUFFOLK, VA 23434-6101
(757) 944-0096
Mailing address
707 GITTINGS ST, SUITE 130, SUFFOLK, VA 23434-6101
(757) 944-0096
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
015349
VA
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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