Healthcare Provider Details

I. General information

NPI: 1053162529
Provider Name (Legal Business Name): BLESSED HANDS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 FORBES AVE
NEW HAVEN CT
06512-1616
US

IV. Provider business mailing address

30 N GOULD ST STE 21248
SHERIDAN WY
82801-6317
US

V. Phone/Fax

Practice location:
  • Phone: 484-279-2179
  • Fax:
Mailing address:
  • Phone: 551-337-1429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: QUINN FENWICK
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 551-337-1429