Heavenly Manor LLC

NPI #1093416497 in Hampton, Virginia

Provider Information

NPI Number: 1093416497
Entity Type: Organization
Organization Name: Heavenly Manor LLC
Primary Specialty: Community Health Worker
Enumeration Date: Mar 13, 2023
Last Updated: Mar 13, 2023

Practice Location

Address: 132 BURNS ST
City: Hampton
State: Virginia
ZIP Code: 23669-4610
Phone: (757) 771-1477

Authorized Official

Name: SHAMECKA LAWANDA DINKINS, RN, MSN
Title: OWNER
Phone: (757) 771-1477

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X	Primary

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