MEDICARE: BLESSED LIFE ASSISTED LIVING FACILITY

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1295679009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESSED LIFE ASSISTED LIVING FACILITY

Provider Business Mailing Address
First Line	:	3815 BRAYTON AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-4224
Country	:	US
Telephone Number	:	562-505-8623
Fax Number	:	562-505-8623

Provider Business Practice Location Address
First Line	:	3815 BRAYTON AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-4224
Country	:	US
Telephone Number	:	562-505-8623
Fax Number	:	562-505-8623

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TOMEKA COLEMAN
Credential	:	COLEMAN
Telephone Number	:	562-505-8623

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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Directions to “BLESSED LIFE ASSISTED LIVING FACILITY ” Practice Location

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