OrganizationHeavenly Home CareAssisted Living FacilityNursing & Custodial Care FacilitiesPractice Address5420 E 99th Ave, Anchorage, AK 99507-6622(907) 245-0994PECOS EnrollmentBased on the most recent information from CMS, provider Heavenly Home Care does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:51 AM.Profile DetailsProvider ID1023226495Provider TypeOrganizationFull NameHeavenly Home CareSubpartNoEnumeration Date5/18/2007Last Updated7/15/2008Contact InformationPractice LocationPractice Address5420 E 99th Ave, Anchorage, AK 99507-6622Phone(907) 245-0994FaxUnlisted FaxMailing LocationMailing Address5420 E 99th Ave, Anchorage, AK 99507-6622Phone(907) 245-0994FaxUnlisted FaxAuthorized OfficialNameWaggoner, Serena Faye (Owner Administrator)Phone(907) 245-0994Provider TaxonomiesCodeDescriptionLicenseCode310400000XPrimaryDescriptionAssisted Living FacilityNursing & Custodial Care FacilitiesLicense000258AlaskaProvider IdentifiersIDDescriptionIssuerIDRL97411DescriptionMedicaidIssuerUnlistedAlaska