Provider Demographics
NPI:1649758160
Name:THE BLESSED HOME CARE LLC
Entity Type:Organization
Organization Name:THE BLESSED HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANETTE
Authorized Official - Middle Name:JULITAN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:651-210-7190
Mailing Address - Street 1:2441 LINWOOD CT E
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55119-5854
Mailing Address - Country:US
Mailing Address - Phone:651-210-7190
Mailing Address - Fax:
Practice Address - Street 1:2441 LINWOOD CT E
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55119
Practice Address - Country:US
Practice Address - Phone:651-210-7190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN386055251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health