Provider Demographics
NPI:1265395222
Name:HEAVENLY HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:HEAVENLY HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADRAIN
Authorized Official - Middle Name:LETISHA
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:864-642-9642
Mailing Address - Street 1:PO BOX 3756
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29622-3756
Mailing Address - Country:US
Mailing Address - Phone:864-221-1441
Mailing Address - Fax:864-686-5777
Practice Address - Street 1:1434A W MARKET ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29624-1328
Practice Address - Country:US
Practice Address - Phone:864-221-1441
Practice Address - Fax:864-686-5777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-06
Last Update Date:2025-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty