1629106273 NPI number — HEAVEN'S TOUCH HOME CARE SERVICES

Table of content: (NPI 1629106273)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629106273 NPI number — HEAVEN'S TOUCH HOME CARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEAVEN'S TOUCH HOME CARE SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629106273
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2023
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KINSTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28502-2023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-522-5984
Provider Business Mailing Address Fax Number:
252-527-9854

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
327 ALEXANDER ROUSE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINSTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28504-7006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-522-5984
Provider Business Practice Location Address Fax Number:
252-527-9854
Provider Enumeration Date:
03/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SKINNER
Authorized Official First Name:
SHIRLEY
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
RN DIRECTOR
Authorized Official Telephone Number:
252-522-5984

Provider Taxonomy Codes

  • Taxonomy code: 3747P1801X , with the licence number:  HC 2457 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3409636 . This is a "C.A.P. PCS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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