MEDICARE: BLESSINGS UNLEASHED FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1083274369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESSINGS UNLEASHED FOUNDATION

Provider Business Mailing Address
First Line	:	2820 BON AYR RD
Second Line	:
City	:	PARK CITY
State	:	KY
Zip	:	42160-7502
Country	:	US
Telephone Number	:	270-670-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2820 BON AYR RD
Second Line	:
City	:	PARK CITY
State	:	KY
Zip	:	42160-7502
Country	:	US
Telephone Number	:	270-670-4000
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DANA HALL
Credential	:
Telephone Number	:	270-670-4000

Provider Enumeration Date	:	06/18/2019
Last Update Date	:	06/18/2019

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Directions to “BLESSINGS UNLEASHED FOUNDATION ” Practice Location

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