Provider Demographics
NPI:1043093883
Name:A WELBLESD HOME LLC
Entity Type:Organization
Organization Name:A WELBLESD HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:BSN-RN
Authorized Official - Phone:804-894-1023
Mailing Address - Street 1:13512 MAHOGANY PL
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-2679
Mailing Address - Country:US
Mailing Address - Phone:804-894-1023
Mailing Address - Fax:804-899-8055
Practice Address - Street 1:13512 MAHOGANY PL
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-2679
Practice Address - Country:US
Practice Address - Phone:804-894-1023
Practice Address - Fax:804-899-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health