Healthcare Provider Details

I. General information

NPI: 1720974264
Provider Name (Legal Business Name): BLESSED HANDS CARE GROUP HOME L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 NE CYPRESS CIR
GRIMES IA
50111-1242
US

IV. Provider business mailing address

1101 NE CYPRESS CIR
GRIMES IA
50111-1242
US

V. Phone/Fax

Practice location:
  • Phone: 484-365-3878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State

VIII. Authorized Official

Name: EMMANUEL L NWACHUKWU
Title or Position: MANAGER
Credential: REGISTERED NURSE
Phone: 484-365-3878