Provider Demographics
NPI:1245091719
Name:HEAVENLY HOPE HOME CARE
Entity type:Organization
Organization Name:HEAVENLY HOPE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CIARRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-445-9657
Mailing Address - Street 1:5428 AFAF ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505-1023
Mailing Address - Country:US
Mailing Address - Phone:810-445-9657
Mailing Address - Fax:
Practice Address - Street 1:5428 AFAF ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-1023
Practice Address - Country:US
Practice Address - Phone:810-445-9657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health