Provider Demographics
NPI:1487079901
Name:HEAVENLY HEALING HOME HEALTH LLC
Entity type:Organization
Organization Name:HEAVENLY HEALING HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:/ADMINISTRATOR/NURSING/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:C/A MEDICINE
Authorized Official - Phone:915-500-5845
Mailing Address - Street 1:8122 TIGUA CIR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-4122
Mailing Address - Country:US
Mailing Address - Phone:915-500-5845
Mailing Address - Fax:915-975-8225
Practice Address - Street 1:11500 PELLICANO DR STE C-6
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6080
Practice Address - Country:US
Practice Address - Phone:915-500-5845
Practice Address - Fax:915-975-8225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-19
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016230251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747967Medicare Oscar/Certification