Provider Demographics
NPI:1235648387
Name:BLESSED & HIGHLY FAVORED HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:BLESSED & HIGHLY FAVORED HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHEA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIDDICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-743-3991
Mailing Address - Street 1:638 INDEPENDENCE PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5222
Mailing Address - Country:US
Mailing Address - Phone:757-620-2298
Mailing Address - Fax:
Practice Address - Street 1:638 INDEPENDENCE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5222
Practice Address - Country:US
Practice Address - Phone:757-743-3991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1810251E00000X
VA3747P1801X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1235648387Medicaid
VA1235648387Medicaid