Provider Demographics
NPI:1992468763
Name:BLESSED HOPE CARE LLC
Entity Type:Organization
Organization Name:BLESSED HOPE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YUFRESSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-677-3093
Mailing Address - Street 1:101 E GIBBSBORO RD APT 1601
Mailing Address - Street 2:
Mailing Address - City:LINDENWOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-1923
Mailing Address - Country:US
Mailing Address - Phone:856-677-3093
Mailing Address - Fax:
Practice Address - Street 1:101 E GIBBSBORO RD APT 1601
Practice Address - Street 2:
Practice Address - City:LINDENWOLD
Practice Address - State:NJ
Practice Address - Zip Code:08021-1923
Practice Address - Country:US
Practice Address - Phone:856-677-3093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0450716803Medicaid