National Provider Identifier Database

HEAVENLY ASSISTED CARE LLC
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.


Contact Information

HEAVENLY ASSISTED CARE, LLC
10555 ASPENWOOD CT
JONESBORO, GA30238
Phone: 404-713-4982
Fax: 678-413-2491
Website:
Specialty Taxonomy Code
* Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320600000X

* Indicates primary specialty

NPI Profile & details for HEAVENLY ASSISTED CARE, LLC

NPI Number 1518297175
Legal business name
LBN
HEAVENLY ASSISTED CARE, LLC
Authorized official HEAVENLY KIMES - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 01/05/2010
Last updated 01/07/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: DN012304
  • GA Medicaid: 481264351A

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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