Provider Demographics
NPI:1619533155
Name:BLESSED ASSURANCE HEALTHCARE
Entity Type:Organization
Organization Name:BLESSED ASSURANCE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GODFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:NWACHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-273-5051
Mailing Address - Street 1:9040 STEBBING WAY APT K
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-5947
Mailing Address - Country:US
Mailing Address - Phone:301-273-5051
Mailing Address - Fax:
Practice Address - Street 1:9040 STEBBING WAY APT K
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-5947
Practice Address - Country:US
Practice Address - Phone:301-273-5051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities