Provider Demographics
NPI:1871103507
Name:ONE HEAVEN INC
Entity type:Organization
Organization Name:ONE HEAVEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-510-5801
Mailing Address - Street 1:102 LAKESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-6240
Mailing Address - Country:US
Mailing Address - Phone:609-510-5801
Mailing Address - Fax:609-396-7739
Practice Address - Street 1:5 ARDSLEY AVE
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08638-2805
Practice Address - Country:US
Practice Address - Phone:609-510-5801
Practice Address - Fax:609-396-7739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging