Healthcare Provider Details

I. General information

NPI: 1326672973
Provider Name (Legal Business Name): BLESSED ELDER CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2020
Last Update Date: 02/22/2020
Certification Date: 02/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5041 SIERRA ST
RIVERSIDE CA
92504-2260
US

IV. Provider business mailing address

5041 SIERRA ST
RIVERSIDE CA
92504-2260
US

V. Phone/Fax

Practice location:
  • Phone: 951-963-5443
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: CASANDRA GURAU
Title or Position: LICENSEE
Credential:
Phone: 951-963-5443