Healthcare Provider Details

I. General information

NPI: 1891954640
Provider Name (Legal Business Name): BLESSING HEART CARE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 06/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 COUNTRY CLUB BLVD
MONROE LA
71202-7302
US

IV. Provider business mailing address

PO BOX 5058
MONROE LA
71211-5058
US

V. Phone/Fax

Practice location:
  • Phone: 318-387-6474
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: CATHY WILLIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 318-387-6474