Healthcare Provider Details

I. General information

NPI: 1164621108
Provider Name (Legal Business Name): BLESSED AT HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16720 US HIGHWAY 52
WEST PORTSMOUTH OH
45663-8894
US

IV. Provider business mailing address

16720 US HIGHWAY 52
WEST PORTSMOUTH OH
45663-8894
US

V. Phone/Fax

Practice location:
  • Phone: 740-727-8032
  • Fax: 740-574-5811
Mailing address:
  • Phone: 740-574-5667
  • Fax: 740-574-5811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. TAMARA J VAN BIBBER
Title or Position: GENERAL MEMBER/VPQI
Credential: RN
Phone: 740-574-5667