| NPI | 1730704487 |
|---|---|
| Former Legal Business Name | HEAVEN'S HAVEN LIVING FACILITY LLC |
| Entity Type | Organization |
| Authorized Contact | CIELITA EZELL Provider 251-509-8641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2021-11-01 |