Provider Demographics
NPI:1043045503
Name:HEAVENLY HANDS HOME CARE LLC
Entity type:Organization
Organization Name:HEAVENLY HANDS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TINIKA G.
Authorized Official - Middle Name:G
Authorized Official - Last Name:LOGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN BS-HCA
Authorized Official - Phone:314-484-0002
Mailing Address - Street 1:1421 RED OAK PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-7348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3925 WRIGHT AVE
Practice Address - Street 2:
Practice Address - City:SAINT ANN
Practice Address - State:MO
Practice Address - Zip Code:63074-1931
Practice Address - Country:US
Practice Address - Phone:314-484-0002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health