Organization
HEAVENLY LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NOEL KANGA SR. (EXECUTIVE DIRECTOR/OWNER)
(804) 481-0313
Entity
Organization
Contact information
Practice address
21101 DEODORA DR, SOUTH CHESTERFIELD, VA 23803-2224
(804) 481-0313
Mailing address
21101 DEODORA DR, SOUTH CHESTERFIELD, VA 23803-2224
(804) 481-0313
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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