Provider Demographics
NPI:1144894973
Name:HEAVENLY SENT HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:HEAVENLY SENT HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAMEEQUR
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-282-8924
Mailing Address - Street 1:5909 FALLS OF THE NEUSE ROAD
Mailing Address - Street 2:STE 100C
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-8510
Mailing Address - Country:US
Mailing Address - Phone:571-282-8924
Mailing Address - Fax:
Practice Address - Street 1:5909 FALLS OF THE NEUSE ROAD
Practice Address - Street 2:100 C
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-8510
Practice Address - Country:US
Practice Address - Phone:571-282-8924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========Medicaid