Provider Demographics
NPI:1871773861
Name:BLESSED HOME 3, INC.
Entity type:Organization
Organization Name:BLESSED HOME 3, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONUORAH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-850-4334
Mailing Address - Street 1:3113 EDGETONE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-3703
Mailing Address - Country:US
Mailing Address - Phone:919-850-2336
Mailing Address - Fax:919-878-5649
Practice Address - Street 1:1120 HARDIMONT RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6838
Practice Address - Country:US
Practice Address - Phone:919-850-4334
Practice Address - Fax:919-878-5649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL092688311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home