Provider Demographics
NPI:1144590142
Name:ETERNAL BLESSINGS PERSONAL CARE SERVICES
Entity Type:Organization
Organization Name:ETERNAL BLESSINGS PERSONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARION
Authorized Official - Middle Name:
Authorized Official - Last Name:PEEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-249-4562
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:LA
Mailing Address - Zip Code:71226-0386
Mailing Address - Country:US
Mailing Address - Phone:318-249-4562
Mailing Address - Fax:
Practice Address - Street 1:6603 HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:LA
Practice Address - Zip Code:71226-9326
Practice Address - Country:US
Practice Address - Phone:318-249-4562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203781015251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA9807Medicaid