Provider Demographics
NPI:1912666959
Name:BLESSEDED HANDS HOME-CARE
Entity Type:Organization
Organization Name:BLESSEDED HANDS HOME-CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-281-8700
Mailing Address - Street 1:3100 E HAWORTH AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2197
Mailing Address - Country:US
Mailing Address - Phone:971-281-8700
Mailing Address - Fax:503-487-6145
Practice Address - Street 1:3100 E HAWORTH AVE STE 230
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2197
Practice Address - Country:US
Practice Address - Phone:971-281-8700
Practice Address - Fax:503-487-6145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care