MEDICARE: JOETTA'S BLESSING LLC

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	385H00000X	Respite Care

General Provider Information

NPI Number	:	1184593717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOETTA'S BLESSING LLC

Provider Business Mailing Address
First Line	:	1036 IVALOO ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23513-3346
Country	:	US
Telephone Number	:	757-895-1691
Fax Number	:	757-895-1691

Provider Business Practice Location Address
First Line	:	1036 IVALOO ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23513-3346
Country	:	US
Telephone Number	:	757-895-1691
Fax Number	:	757-895-1691

Authorized Official
Title or Position	:	OWNER
Name	:	CHERRAL EVANS
Credential	:
Telephone Number	:	757-995-9986

Provider Enumeration Date	:	11/03/2025
Last Update Date	:	04/09/2026

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