Healthcare Provider Details
I. General information
NPI: 1992673289
Provider Name (Legal Business Name): JESUS BLESS FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
185 WILLIS AVE
MINEOLA NY
11501-2671
US
IV. Provider business mailing address
22713 113TH DR
QUEENS VILLAGE NY
11429-2722
US
V. Phone/Fax
- Phone: 800-593-1303
- Fax:
- Phone: 800-593-1303
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DURRAINE
DUNN
Title or Position: COO
Credential:
Phone: 516-467-6071