Provider Demographics
NPI:1184503344
Name:HEAVENS COVERAGE LLC
Entity type:Organization
Organization Name:HEAVENS COVERAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CDS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAQUIESHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-281-6436
Mailing Address - Street 1:10416 BARON DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 CHURCH ST STE 209E
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135-2458
Practice Address - Country:US
Practice Address - Phone:314-281-6436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health