Provider Demographics
NPI:1417636671
Name:BLESSED HEARTS HOME HEALTH LLC
Entity Type:Organization
Organization Name:BLESSED HEARTS HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FULCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-919-8188
Mailing Address - Street 1:PO BOX 16716
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-6711
Mailing Address - Country:US
Mailing Address - Phone:870-253-6812
Mailing Address - Fax:
Practice Address - Street 1:2424 E MATTHEWS AVE STE G
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4485
Practice Address - Country:US
Practice Address - Phone:870-666-0531
Practice Address - Fax:870-275-6599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty