Provider Demographics
NPI:1518529536
Name:BEYOND BLESSED SUPPORTIVE SERVICES, LLC
Entity Type:Organization
Organization Name:BEYOND BLESSED SUPPORTIVE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELISHA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:WALDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-315-2122
Mailing Address - Street 1:1638 CELESTE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-4323
Mailing Address - Country:US
Mailing Address - Phone:706-940-1362
Mailing Address - Fax:762-821-3674
Practice Address - Street 1:1638 CELESTE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-4323
Practice Address - Country:US
Practice Address - Phone:706-940-1362
Practice Address - Fax:762-821-3674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-29
Last Update Date:2019-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility