Healthcare Provider Details

I. General information

NPI: 1275387979
Provider Name (Legal Business Name): BLESSED HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

484 WILSON AVE
COLUMBUS OH
43205-1945
US

IV. Provider business mailing address

PO BOX 6265
COLUMBUS OH
43206-0265
US

V. Phone/Fax

Practice location:
  • Phone: 614-309-0959
  • Fax:
Mailing address:
  • Phone: 614-309-0959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. YOULANDA JAMES-TATE
Title or Position: REGISTERED NURSE
Credential: RN
Phone: 614-309-0959