Provider Demographics
NPI:1851084040
Name:NIQUE'NYCOLES BLESSINGS & ANGELS HOMEMAKER AND COMPANION SERVICES LLC
Entity Type:Organization
Organization Name:NIQUE'NYCOLES BLESSINGS & ANGELS HOMEMAKER AND COMPANION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:813-446-1975
Mailing Address - Street 1:4011 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33711-1216
Mailing Address - Country:US
Mailing Address - Phone:727-798-3250
Mailing Address - Fax:
Practice Address - Street 1:4011 3RD AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-1216
Practice Address - Country:US
Practice Address - Phone:727-798-3250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-01
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health