Organization
HEAVENLY HOMECARE AGENCY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNETTE K LEE (OWNER)
(347) 998-2976
Entity
Organization
Contact information
Practice address
3817 CASSANDRA RD, RANDALLSTOWN, MD 21133-3322
(347) 998-2976
(410) 630-5024
Mailing address
3817 CASSANDRA RD, RANDALLSTOWN, MD 21133-3322
(347) 998-2976
(410) 630-5024
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/19/2017
Last updated
10/19/2017
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