Organization
HEAVENLY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANOBAYITA DORIS (PRESIDENT)
(601) 316-1347
Entity
Organization
Contact information
Practice address
6984 W CAVALIER DR, GLENDALE, AZ 85303-4435
(160) 131-6347
Mailing address
6513 W CARIBBEAN LN, GLENDALE, AZ 85306-3152
(601) 316-1347
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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