Provider Demographics
NPI:1407465305
Name:BLISSFUL PRIMARY HOME CARE LLC
Entity Type:Organization
Organization Name:BLISSFUL PRIMARY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:956-482-5376
Mailing Address - Street 1:905 MCCLELLAND AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-6281
Mailing Address - Country:US
Mailing Address - Phone:956-482-5376
Mailing Address - Fax:956-704-5554
Practice Address - Street 1:905 MCCLELLAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-6281
Practice Address - Country:US
Practice Address - Phone:956-482-5376
Practice Address - Fax:956-704-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome Health