HEAVENLY PLACE LLC II
NPI 1356683445
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Raleigh, NC

Active since March 27, 2013CLIA Certified · 2 labs
2105 GRESHAM LAKE RD, RALEIGH, NC 27615(919) 819-3882 Get Directions Write a Review

NPPES record last updated: March 27, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Heavenly Place Llc Ii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEAVENLY PLACE LLC II (NPI 1356683445) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Raleigh, North Carolina and active in the NPI registry since March 2013. The organization holds 2 active CLIA laboratory certificates and lists Juliet Okwoshah, Administration, as its authorized official.

NPPES Registry Identity

NPI1356683445
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameHEAVENLY PLACE LLC II
Location Address2105 GRESHAM LAKE RDRaleigh, NC 27615-4204
Mailing AddressPo Box 41153Raleigh, NC 27629-1153
Organization SubpartNo
Authorized OfficialJuliet OkwoshahAdministration · (919) 819-3882
Enumeration DateMarch 27, 2013
NPI 1356683445 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
Definition

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.

2105 GRESHAM LAKE RD, Raleigh, NC 27615

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2207889

Heavenly Place LLC · Raleigh, NC
Active · expires Dec 30, 2026
CLIA Number34D2207889
Laboratory TypeMental Health
Certificate Effective DateDecember 31, 2024
Certificate Expiration DateDecember 30, 2026
Laboratory DirectorJames Abe
Laboratory Phone(919) 819-3882
Laboratory LocationHeavenly Place LLC3120 Tuckland Drive, Raleigh, NC 27610
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2206321

Heavenly Place LLC · Raleigh, NC
Active · expires Dec 17, 2026
CLIA Number34D2206321
Laboratory TypeMental Health Facility
Certificate Effective DateDecember 18, 2024
Certificate Expiration DateDecember 17, 2026
Laboratory DirectorJames Abe
Laboratory Phone(919) 819-3882
Laboratory LocationHeavenly Place LLC8600 Neuse Hunter Road, Raleigh, NC 27616
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Custodial Care Facility (Adult Care Home)
2105 GRESHAM LAKE RD
RALEIGH, NC 27615

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heavenly Place LLC II's NPI number?

The NPI number for Heavenly Place LLC II is 1356683445. It was assigned to this organization in the NPPES registry on March 27, 2013.

Where is Heavenly Place LLC II located?

Heavenly Place LLC II is located at 2105 Gresham Lake Rd, Raleigh, NC 27615. The listed phone number is (919) 819-3882.

What is Heavenly Place LLC II's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

Does Heavenly Place LLC II hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Heavenly Place LLC II was last updated on March 27, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.