Provider Demographics
NPI:1972883346
Name:A BLESSED ASSURANCE HOME CARE AGENCY
Entity Type:Organization
Organization Name:A BLESSED ASSURANCE HOME CARE AGENCY
Other - Org Name:A BLESSED ASSURANCE HOME CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FELECIA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-243-5900
Mailing Address - Street 1:2775 VILLA CREEK DR
Mailing Address - Street 2:SUITE170
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7432
Mailing Address - Country:US
Mailing Address - Phone:972-243-5900
Mailing Address - Fax:
Practice Address - Street 1:2775 VILLA CREEK DR
Practice Address - Street 2:SUITE170
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7432
Practice Address - Country:US
Practice Address - Phone:972-243-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013515251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health