Provider Demographics
NPI:1093003022
Name:BLESSED JOURNEY HEALTHCARE, L.L.C.
Entity Type:Organization
Organization Name:BLESSED JOURNEY HEALTHCARE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:DIONNE
Authorized Official - Last Name:ROOTS-BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-227-6777
Mailing Address - Street 1:PO BOX 225
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-0006
Mailing Address - Country:US
Mailing Address - Phone:770-227-6777
Mailing Address - Fax:770-227-6770
Practice Address - Street 1:125 W SOLOMON ST
Practice Address - Street 2:SUITE D
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-3017
Practice Address - Country:US
Practice Address - Phone:770-227-6777
Practice Address - Fax:770-227-6770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA126-R-0893253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care