Provider Demographics
NPI:1578059465
Name:BLESSING HANDS HOME HEALTH LLC
Entity Type:Organization
Organization Name:BLESSING HANDS HOME HEALTH LLC
Other - Org Name:VITALUS HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:MSN RN
Authorized Official - Phone:281-240-0749
Mailing Address - Street 1:509 W TIDWELL RD STE 318
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-4355
Mailing Address - Country:US
Mailing Address - Phone:281-240-1335
Mailing Address - Fax:
Practice Address - Street 1:509 W TIDWELL RD STE 318
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-4355
Practice Address - Country:US
Practice Address - Phone:281-240-1335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX018751251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========8OtherMEDICARE