Provider Demographics
NPI:1528584604
Name:HEAVENLY HOME HEALTH AID INC.
Entity type:Organization
Organization Name:HEAVENLY HOME HEALTH AID INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAUGHLIN WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-433-1660
Mailing Address - Street 1:3760 CURTIS BLVD STE 604
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32927-3964
Mailing Address - Country:US
Mailing Address - Phone:321-433-1660
Mailing Address - Fax:321-252-0404
Practice Address - Street 1:3760 CURTIS BLVD STE 604
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32927-3964
Practice Address - Country:US
Practice Address - Phone:321-433-1660
Practice Address - Fax:321-252-0404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNR30211845253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care