Provider Demographics
NPI:1033864921
Name:2 BLESSING HANDS
Entity Type:Organization
Organization Name:2 BLESSING HANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOUNAS
Authorized Official - Middle Name:LUNE
Authorized Official - Last Name:IDALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-548-8671
Mailing Address - Street 1:5211 NW 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4903
Mailing Address - Country:US
Mailing Address - Phone:954-548-8671
Mailing Address - Fax:
Practice Address - Street 1:5211 NW 84TH AVE
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-4903
Practice Address - Country:US
Practice Address - Phone:954-548-8671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016151400Medicaid