Healthcare Provider Details

I. General information

NPI: 1215731062
Provider Name (Legal Business Name): TRULY BLESSED BLISS HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W HOWARD AVE STE 11B
TARBORO NC
27886-4154
US

IV. Provider business mailing address

1600 W HOWARD AVE STE 11B
TARBORO NC
27886-4154
US

V. Phone/Fax

Practice location:
  • Phone: 252-400-1119
  • Fax:
Mailing address:
  • Phone: 252-400-1119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: TALORA BLACKWELL
Title or Position: ADMIN
Credential:
Phone: 252-400-1119