Provider Demographics
NPI:1396142469
Name:BLASSINGAME HOME CARE LLC
Entity type:Organization
Organization Name:BLASSINGAME HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BLASSINGAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-286-2273
Mailing Address - Street 1:1835 NW TOPEKA BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66608-1892
Mailing Address - Country:US
Mailing Address - Phone:785-286-2273
Mailing Address - Fax:785-232-8618
Practice Address - Street 1:1835 NW TOPEKA BLVD STE 205
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66608-1892
Practice Address - Country:US
Practice Address - Phone:785-286-2273
Practice Address - Fax:785-232-8618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200962180AMedicaid