Provider Demographics
NPI:1952665507
Name:BE BLESSED ADULT CARE SERVICE
Entity Type:Organization
Organization Name:BE BLESSED ADULT CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TONIA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:AMBUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-496-3848
Mailing Address - Street 1:10262 PAGE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-1322
Mailing Address - Country:US
Mailing Address - Phone:314-496-3848
Mailing Address - Fax:314-395-9655
Practice Address - Street 1:10262 PAGE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-1322
Practice Address - Country:US
Practice Address - Phone:314-496-3848
Practice Address - Fax:314-395-9655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health