Provider Demographics
NPI:1790025021
Name:BLESSING HOME HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:BLESSING HOME HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KPEGNON
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSOUMANOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-620-8628
Mailing Address - Street 1:20302 GRAZING WAY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-1210
Mailing Address - Country:US
Mailing Address - Phone:240-620-8628
Mailing Address - Fax:301-685-3588
Practice Address - Street 1:20302 GRAZING WAY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-1210
Practice Address - Country:US
Practice Address - Phone:240-620-8628
Practice Address - Fax:301-685-3588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-23
Last Update Date:2013-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3411251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care