HEAVENLY ANGELS LLC (NPI# 1700367174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700367174 |
| Entity Type | Organization |
| Organization Name | HEAVENLY ANGELS LLC |
| Practice Address |
1333 E Broad St West Point MS 39773-3180 |
| Practice Telephone | 6622953257 |
| Practice Fax Number | 6625243536 |
| Mailing Telephone | 6622953257 |
| Mailing Fax Number | 6625243536 |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2020-10-30 |
| Authorized Official Name | ANGELA RICE (PRESIDENT) |
| Authorized Official Telephone | 6622953257 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311Z00000X | Custodial Care Facility | Nursing & Custodial Care Facilities | ||
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | HEAVENLY ANGELS LLC | 6522 Ardmore Dr, Lakewood, WA 98499 |
| Oklahoma Business Registrations | HEAVENLY ANGELS LLC | 8729 Silver Creek, Spencer, OK 73084 |
| Street Address |
1333 E BROAD ST |
| City | WEST POINT |
| State | MS |
| Zip Code | 39773-3180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275014490 | Angela Rice | Home Health Aide | 1333 E Broad St, West Point, MS 39773-3180 | 2018-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114532587 | David Vincent Hughes Jr. | Specialist/Technologist | 1 Priority Plaza, West Point, MS 39773 | 2020-09-13 |
| 1548809833 | Karen Annabelle Cuesta | Physical Therapist | 1122 N. Eshman Avenue, West Point, MS 39773 | 2020-01-03 |
| 1235780784 | Kimberly Kay Patterson | Pharmacist | 5509 Us-45 Alt S, West Point, MS 39773 | 2019-09-26 |
| 1821584673 | Amber L Brasfield | Nurse Practitioner | 5713 Hwy 45 Alt S, West Point, MS 39773 | 2018-07-05 |
| 1285185322 | Jordana Baker | Pharmacist | 5509 Highway 45 Alternate, West Point, MS 39773 | 2016-10-24 |
| 1144685900 | Renal Care Group Tupelo, LLC | Clinic/Center | 1612 West Church Hill Road, West Point, MS 39773 | 2015-12-22 |
| 1326437864 | Amber Orman | Behavioral Analyst | 222 Mary Holmes Drive, West Point, MS 39773 | 2015-01-22 |
| 1972945780 | Point City Drugs LLC | Pharmacy | 7683 Highway 45 Alt N, West Point, MS 39773 | 2013-07-22 |
| 1932409083 | Barbrette A. Baldwin | Obstetrics & Gynecology | 373 Medical Center Cir, West Point, MS 39773 | 2010-10-22 |
| 1801112115 | Dawn M Holmes | Counselor | 223 Court St, West Point, MS 39773 | 2010-04-12 |
| Find all providers in zip 39773 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023468923 | Mattie Trammell | Custodial Care Facility | 1008 E 12th St, West Point, GA 31833-1745 | 2016-06-21 |
| 1710303847 | Evalene Flournoy | Custodial Care Facility | 5365 Whitesville Rd, West Point, GA 31833-5001 | 2014-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912540428 | Jennifer Lashon May | Custodial Care Facility | 141 Jefferson Street Ste, C, Monticello, MS 39654-3965 | 2019-10-28 |
| 1255866059 | Personal Touch LLC | Custodial Care Facility | 614 Chippewah Dr, Laurel, MS 39443-7413 | 2017-04-29 |
| 1164964003 | Creative Image Personal Care Service LLC | Custodial Care Facility | 503 Highway 82 E, Indianola, MS 38751-2317 | 2016-11-09 |
| 1679943310 | Educare Senior Day Center (vicksburg Branch) | Custodial Care Facility | 3202 Wisconsin Ave, Vicksburg, MS 39180-5351 | 2015-10-06 |
| 1659747988 | Aging Gracefully Community Center | Custodial Care Facility | 16165 Highway 51, Hazlehurst, MS 39083-2002 | 2015-08-20 |
| 1215315528 | Serenityhomecare | Custodial Care Facility | 1512 Clinton Raymond Rd, Clinton, MS 39056-5400 | 2015-05-07 |
| 1356765101 | Healthyland Adult Day Care, LLC | Custodial Care Facility | 227 Pecan Street, Marks, MS 38646 | 2014-02-14 |
| 1164845210 | R S Enterprise | Custodial Care Facility | 532 Burns St, Jackson, MS 39203-3601 | 2014-01-26 |
| 1053746487 | Assurance Home Care Agency LLC | Custodial Care Facility | 1549 Shiloh Church Rd, Newton, MS 39345-9024 | 2013-09-04 |
| 1790119519 | Pressicare, Inc | Custodial Care Facility | 20434 Old Houston Rd, Aberdeen, MS 39730-8548 | 2013-08-28 |
| Find all providers with the same taxonomy | ||||
| City | WEST POINT |
| Zip Code | 39773 |
Please comment or provide details below to improve the information on HEAVENLY ANGELS LLC.
| 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.