Healthcare Provider Details

I. General information

NPI: 1629985726
Provider Name (Legal Business Name): BLESSED HANDS, MIND & BODY HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S DELSEA DR APT K8
CLAYTON NJ
08312-2239
US

IV. Provider business mailing address

315 S DELSEA DR APT K8
CLAYTON NJ
08312-2239
US

V. Phone/Fax

Practice location:
  • Phone: 856-392-3985
  • Fax: 650-263-7272
Mailing address:
  • Phone: 856-392-3985
  • Fax: 650-263-7272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LEONA SERETHA ALLEN
Title or Position: OWNER & PROVDIER
Credential:
Phone: 856-265-1591