MEDICARE: BLAKES BLESSING HEALTH CARE INC.

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	3747P1801X	Personal Care Attendant
2	251E00000X	Home Health Agency	013719	TX

General Provider Information

NPI Number	:	1679896484
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLAKES BLESSING HEALTH CARE INC.

Provider Business Mailing Address
First Line	:	2646 S LOOP W STE 422
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2678
Country	:	US
Telephone Number	:	832-539-1999
Fax Number	:	713-432-1701

Provider Business Practice Location Address
First Line	:	2646 S LOOP W STE 422
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2678
Country	:	US
Telephone Number	:	832-539-1999
Fax Number	:	713-432-1701

Authorized Official
Title or Position	:	OWNER/ ASSISTANT ADMINISTRATOR
Name	:	MARIE JONES
Credential	:
Telephone Number	:	832-539-1999

Provider Enumeration Date	:	03/08/2010
Last Update Date	:	03/25/2021

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