Provider Demographics
NPI:1598479685
Name:BLESSED CARE, INCORPORATED
Entity Type:Organization
Organization Name:BLESSED CARE, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-480-9757
Mailing Address - Street 1:1410 OAK PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8848
Mailing Address - Country:US
Mailing Address - Phone:337-480-9757
Mailing Address - Fax:337-480-4243
Practice Address - Street 1:1410 OAK PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8848
Practice Address - Country:US
Practice Address - Phone:337-480-9757
Practice Address - Fax:337-480-4243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1004791Medicaid