HEAVENLY ASSISTED CARE, LLC (NPI# 1518297175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518297175 |
| Entity Type | Organization |
| Organization Name | HEAVENLY ASSISTED CARE, LLC |
| Practice Address |
10555 Aspenwood Ct Jonesboro GA 30238 |
| Mailing Address |
3240 Glencree Rd Conyers GA 30012-8836 |
| Practice Telephone | 4047134982 |
| Practice Fax Number | 6784132491 |
| Mailing Telephone | 4047134982 |
| Mailing Fax Number | 6784132491 |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2010-01-07 |
| Authorized Official Name | DR. HEAVENLY E. KIMES (PRESIDENT) |
| Authorized Official Telephone | 6786257505 |
| Authorized Official Credential | D.D.S |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | DN012304 | GA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 481264351A | 05 |
| Street Address |
10555 ASPENWOOD CT |
| City | JONESBORO |
| State | GA |
| Zip Code | 30238 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366969636 | K&p Gentle Hnads Homecare | Home Health | 772 Pointe South Pkwy, Apt. 501, Jonesboro, GA 30238 | 2017-08-27 |
| 1568991214 | Rehab Medical, Inc | Durable Medical Equipment & Medical Supplies | 8568 Highway 85, Jonesboro, GA 30238 | 2017-06-07 |
| 1821472077 | Surgivue First Assisting | Nurse Practitioner | 5865 Sinclair Way, Jonesboro, GA 30238 | 2015-07-17 |
| 1518384106 | Visions of Life Behavioral Health Services, Incorporated | Counselor | 754 Chapman Street, Jonesboro, GA 30238 | 2014-03-21 |
| 1942560206 | Terri L Lee | Counselor | 7899 Waterwheel Way, Jonesboro, GA 30238 | 2012-05-21 |
| 1265704985 | Visiting Homecare Support Services, Inc. | Home Health | 10886 Tara Village Way, Jonesboro, GA 30238 | 2012-01-27 |
| 1649419821 | Carmen Melton Douglas | Speech-Language Pathologist | 10354 Shepperton Court, Jonesboro, GA 30238 | 2009-02-12 |
| 1205050259 | Caryn Ann Grzesiakowski | Chiropractor | 809 Flint River Road, Suite #4, Jonesboro, GA 30238 | 2007-04-12 |
| 1548325483 | Janet Musser Granski | Social Worker | 110 North Bend Court, Jonesboro, GA 30238 | 2006-12-22 |
| 1205276763 | A2bee Transportation LLC | Private Vehicle | 8964 Habersham Dr, Jonesboro, GA 30238 | 2013-06-28 |
| Find all providers in zip 30238 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609045608 | Creative Growth | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9695 Washington Cir, Jonesboro, GA 30238-6094 | 2008-02-22 |
| 1962617282 | Morning Light, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1564 S Hudson Ave, Jonesboro, LA 71251-4022 | 2007-05-11 |
| 1568686947 | Lincoln Square | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 202 South Main St, Jonesboro, IL 62952-0112 | 2007-04-13 |
| 1386770030 | State of Arkansas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4701 Colony Dr, Jonesboro, AR 72404-9317 | 2007-02-26 |
| 1720322563 | Loving Touch Christian Academy, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 7130 Mount Zion Blvd, Suite 11, Jonesboro, GA 30236-2566 | 2012-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437764925 | Calveina Forde | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 538 Country Lake Dr, Mcdonough, GA 30252-2683 | 2020-09-10 |
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1023677713 | Earlean Blackwell | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1865 Waldrep Cir Se, Marietta, GA 30060-4927 | 2019-06-06 |
| 1629535216 | Carpenter Host Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 806 Grady Ave N, Douglas, GA 31533-4812 | 2019-03-01 |
| 1700354859 | View Point Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 160 Longstreet Cir, Oxford, GA 30054-2244 | 2018-11-07 |
| 1760950901 | View Point Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2116 Tudor Castle Cir, Decatur, GA 30035-2158 | 2018-11-06 |
| 1144747437 | Willie Mae Berry Pugh | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2013 Teal Court, Hephzibah, GA 30815 | 2017-08-28 |
| 1881116721 | Springhill Manor Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 600 Spring Hill Drive, Covington, GA 30016 | 2017-07-12 |
| 1093175283 | Peaceful River Residential Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 746 Rudgate Rd, Columbus, GA 31904-2929 | 2016-03-01 |
| 1548649494 | Prestige Community Living Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2328 Bigwood Trl, Atlanta, GA 30349-9049 | 2015-05-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.