Provider Demographics
NPI:1952757734
Name:BLESS INTO UNIQUE CARE AGENCY
Entity Type:Organization
Organization Name:BLESS INTO UNIQUE CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:G
Authorized Official - Last Name:DORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-919-3546
Mailing Address - Street 1:525 BRANCH WAY CT APT K
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-6019
Mailing Address - Country:US
Mailing Address - Phone:803-524-2741
Mailing Address - Fax:
Practice Address - Street 1:415 E WOODLAWN RD # UNITE6
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-2801
Practice Address - Country:US
Practice Address - Phone:803-524-2741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care