National Provider Identifier Database

HEAVENLY ANGELS HOME OF CARE PCH 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 ANGELS HOME OF CARE PCH, LLC
5530 SWANSON RD
ELLENWOOD, GA30294-3857
Phone: 404-361-8485
Fax: 404-393-9382
Website:
Specialty Taxonomy Code
* Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320600000X
Residential Treatment Facility, Physical Disabilities 320700000X

* Indicates primary specialty

NPI Profile & details for HEAVENLY ANGELS HOME OF CARE PCH, LLC

NPI Number 1942561717
Legal business name
LBN
HEAVENLY ANGELS HOME OF CARE PCH, LLC
Authorized official AYANNA BROWN - (CEO)
Entity Organization
Organization subpart No
Enumeration date 06/07/2012
Last updated 06/07/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: PCH006734

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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