Provider Demographics
NPI:1376305581
Name:BLESS UP HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:BLESS UP HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KETTY
Authorized Official - Middle Name:FORGWI
Authorized Official - Last Name:MOFOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-986-2402
Mailing Address - Street 1:6975 MCCLEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-7257
Mailing Address - Country:US
Mailing Address - Phone:443-986-2402
Mailing Address - Fax:
Practice Address - Street 1:6975 MCCLEAN BLVD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-7257
Practice Address - Country:US
Practice Address - Phone:443-986-2402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health