Provider Demographics
NPI:1043349293
Name:BLESSED ASSURANCE COMMUNITY SERVICES LLC
Entity Type:Organization
Organization Name:BLESSED ASSURANCE COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:W
Authorized Official - Last Name:STROBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-833-0210
Mailing Address - Street 1:10233 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:KY
Mailing Address - Zip Code:40107-8607
Mailing Address - Country:US
Mailing Address - Phone:502-833-0210
Mailing Address - Fax:502-833-0510
Practice Address - Street 1:10233 BOSTON RD
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:KY
Practice Address - Zip Code:40107-8607
Practice Address - Country:US
Practice Address - Phone:502-833-0210
Practice Address - Fax:502-833-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY17000621Medicaid