Provider Demographics
NPI:1346881455
Name:BLESSIT HANDS PERSONAL CARE AGENCY
Entity Type:Organization
Organization Name:BLESSIT HANDS PERSONAL CARE AGENCY
Other - Org Name:BLESSITHANDS PERSONAL CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELECTISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEARS-HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-588-1337
Mailing Address - Street 1:5019 W NORTH AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-1121
Mailing Address - Country:US
Mailing Address - Phone:414-585-0173
Mailing Address - Fax:414-239-8166
Practice Address - Street 1:7332 W STATE ST # 2
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213-2766
Practice Address - Country:US
Practice Address - Phone:414-585-0173
Practice Address - Fax:414-239-8166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100079511Medicaid