Provider Demographics
NPI: | 1942809488 |
---|---|
Name: | HEAVENLY TOUCH OF CLASS HOMEMAKER & COMPANION SERVICES, LLC |
Entity type: | Organization |
Organization Name: | HEAVENLY TOUCH OF CLASS HOMEMAKER & COMPANION SERVICES, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SHANNON |
Authorized Official - Middle Name: | N |
Authorized Official - Last Name: | TURNER-ANDERSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MSN, PMHNP-BC |
Authorized Official - Phone: | 813-995-5682 |
Mailing Address - Street 1: | 2824 WINDGUARD CIR STE 101 |
Mailing Address - Street 2: | |
Mailing Address - City: | WESLEY CHAPEL |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33544-7369 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 813-995-5682 |
Mailing Address - Fax: | 813-501-4035 |
Practice Address - Street 1: | 2824 WINDGUARD CIR STE 101 |
Practice Address - Street 2: | |
Practice Address - City: | WESLEY CHAPEL |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33544-7369 |
Practice Address - Country: | US |
Practice Address - Phone: | 813-995-5682 |
Practice Address - Fax: | 813-501-4035 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-10-24 |
Last Update Date: | 2024-05-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
No | 163WP0807X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health, Child & Adolescent |
No | 163WP0808X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health |
No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
No | 251E00000X | Agencies | Home Health | |
No | 253J00000X | Agencies | Foster Care Agency | |
No | 253Z00000X | Agencies | In Home Supportive Care | |
No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
No | 364SL0600X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Long-Term Care |
No | 373H00000X | Nursing Service Related Providers | Day Training/Habilitation Specialist | |
No | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant |
No | 374U00000X | Nursing Service Related Providers | Home Health Aide | |
No | 376K00000X | Nursing Service Related Providers | Nurse's Aide | |
No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child |