Provider Demographics
NPI:1528576063
Name:BE A BLESSING HEALTH SERVICES
Entity Type:Organization
Organization Name:BE A BLESSING HEALTH SERVICES
Other - Org Name:BE A BLESSING HEALTH SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-900-1118
Mailing Address - Street 1:PO BOX 646
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33595-0646
Mailing Address - Country:US
Mailing Address - Phone:813-900-1118
Mailing Address - Fax:
Practice Address - Street 1:200 W MADISON ST STE 2100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-3521
Practice Address - Country:US
Practice Address - Phone:813-900-1118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicaid
IL=========Medicaid