Provider Demographics
NPI:1366871964
Name:HEAVENLY HANDS OF VA
Entity type:Organization
Organization Name:HEAVENLY HANDS OF VA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WATLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-851-3367
Mailing Address - Street 1:PO BOX 323
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:24572-0323
Mailing Address - Country:US
Mailing Address - Phone:434-851-3367
Mailing Address - Fax:
Practice Address - Street 1:1607 WARDS FERRY RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2423
Practice Address - Country:US
Practice Address - Phone:434-851-3367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care