HEAVENLY HOMECARE SERVICES (NPI# 1902229453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902229453 |
| Entity Type | Organization |
| Organization Name | HEAVENLY HOMECARE SERVICES |
| Practice Address |
4980 Villager Ln Stone Mountain GA 30083-3698 |
| Practice Telephone | 6783624708 |
| Mailing Telephone | 6783624708 |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2014-02-03 |
| Authorized Official Name | TAMEKA LASEAN WILLIAMS (OWNER) |
| Authorized Official Telephone | 6783624708 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 253Z00000X | In Home Supportive Care | Agencies | ||
| N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility | ||
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
4980 VILLAGER LN |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30083-3698 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558830919 | Patriot Healthcare of Georgia, LLC | Family Medicine | 833 Hairston Road, Stone Mountain, GA 30083 | 2018-11-15 |
| 1710403431 | Trans Med Ems,llc | Ambulance | 4683 Redan Rd, Stone Mountain, GA 30083 | 2017-08-15 |
| 1447770482 | Dispatched Angels Home Care | In Home Supportive Care | 619 El Prado Court, Stone Mountain, GA 30083 | 2017-06-21 |
| 1396191086 | Suzanne Carter | Chore Provider | 1036 Allgood Rd, Stone Mountain, GA 30083 | 2016-05-11 |
| 1437520087 | Meaza Dada | Pharmacist | 1043 Thornwoode Lane, Stone Mountain, GA 30083 | 2015-10-08 |
| 1427436500 | Raeanne Elizabeth Gialanella | Occupational Therapist | 5839 Memorial Drive, Stone Mountain, GA 30083 | 2015-05-11 |
| 1265829824 | Latore Williams | Licensed Practical Nurse | 5300 Ridge Forest Drive, Stone Mountain, GA 30083 | 2015-04-22 |
| 1144625922 | Granville Theodore Freeman IIi | Counselor | 5000 Brittany Drive, Stone Mountain, GA 30083 | 2014-10-23 |
| 1588974208 | Terri R Collins | Counselor | 1020 Strap Hinge Trail, Stone Mountain, GA 30083 | 2010-10-15 |
| 1104064815 | Vistas Medical Center,pc | Clinic/Center | 5329 Memorial Dr Ste A, Stone Mountain, GEORGIA 30083 | 2009-02-03 |
| Find all providers in zip 30083 | ||||
| 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 |
|---|---|---|---|---|
| 1881901874 | Rachels' Personal Care Home Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1285 Muirforest Way, Stone Mountain, GA 30088-3235 | 2010-09-11 |
| 1306077953 | Ultimate Living Services, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1516 Crooked Tree Cir, Stone Mountain, GA 30088-3723 | 2009-07-30 |
| 1679614309 | New Ray of Hope, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 588 Kingsgate Rdg, Stone Mountain, GA 30088-1828 | 2007-02-08 |
| 1457783789 | Bryana Personal Care Home, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6276 Field Glen Rd, Stone Mountain, GA 30087-4911 | 2013-08-09 |
| 1851626733 | Ultimate Living Service, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1516 Crooked Tree Cir, Stone Mountain, GA 30088-3723 | 2009-10-09 |
| 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 | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30083 |
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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.