Organization
HEAVENLY HOME CARE
Active
Organization
HEAVENLY HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OGECHI EZIMAKO (OWNER)
(512) 642-3404
Entity
Organization
Contact information
Practice address
145 SULPHUR RIVER LOOP, HUTTO, TX 78634-4466
(512) 642-3404
Mailing address
145 SULPHUR RIVER LOOP, HUTTO, TX 78634-4466
(512) 642-3404
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
374700000X
Technician
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
374T00000X
Religious Nonmedical Nursing Personnel
—
—
374U00000X
Home Health Aide
Primary
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
10/17/2019
Last updated
01/03/2020
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