Healthcare Provider Details

I. General information

NPI: 1568021293
Provider Name (Legal Business Name): BLESSED LIFE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2273 BARATARIA BLVD STE 1&2
MARRERO LA
70072-5456
US

IV. Provider business mailing address

PO BOX 750423
NEW ORLEANS LA
70175-0423
US

V. Phone/Fax

Practice location:
  • Phone: 504-518-6383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: KEIMYEREIA RAILYNN LEWIS-JONES
Title or Position: OWNER
Credential:
Phone: 504-518-6383