MEDICARE: BEYONDBLESSEDD 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1578381224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYONDBLESSEDD LLC

Provider Business Mailing Address
First Line	:	756 DOLPHIN ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21217-2931
Country	:	US
Telephone Number	:	202-938-8565
Fax Number	:

Provider Business Practice Location Address
First Line	:	756 DOLPHIN ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21217-2931
Country	:	US
Telephone Number	:	202-938-8565
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AISSATOU SOW
Credential	:
Telephone Number	:	202-938-8565

Provider Enumeration Date	:	10/01/2024
Last Update Date	:	01/29/2026

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Directions to “BEYONDBLESSEDD LLC ” Practice Location

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