Provider Demographics
NPI:1629641196
Name:BLUE ORCHID HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:BLUE ORCHID HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAKESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICKARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-865-4917
Mailing Address - Street 1:163 STRATFORD CT
Mailing Address - Street 2:STE 240
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1860
Mailing Address - Country:US
Mailing Address - Phone:336-999-7480
Mailing Address - Fax:
Practice Address - Street 1:163 STRATFORD CT
Practice Address - Street 2:STE 240
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1860
Practice Address - Country:US
Practice Address - Phone:336-999-7480
Practice Address - Fax:336-999-8335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No251E00000XAgenciesHome Health
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty