Healthcare Provider Details
I. General information
NPI: 1740023605
Provider Name (Legal Business Name): BLISSFUL BRIDGES HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2024
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11720 N CHARLOTTE ST
KANSAS CITY MO
64155-1092
US
IV. Provider business mailing address
11720 N CHARLOTTE ST
KANSAS CITY MO
64155-1092
US
V. Phone/Fax
- Phone: 816-423-3034
- Fax:
- Phone: 816-423-3034
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EMMA
VENN
Title or Position: OWNER
Credential:
Phone: 816-423-3034