=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053087130
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLESSINGS TREATMENT AND RECOVERY CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/19/2021
-----------------------------------------------------
Last Update Date | 05/15/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6736 FOREST AVE
-----------------------------------------------------
City | NEW PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34653-2510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-220-2422
-----------------------------------------------------
Fax | 727-264-0462
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5319 GRAND BLVD
-----------------------------------------------------
City | NEW PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34652-4014
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-842-6916
-----------------------------------------------------
Fax | 727-264-0462
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/OWNER
-----------------------------------------------------
Name | KEVIN SIMMONS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 813-785-8911
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 323P00000X
-----------------------------------------------------
Taxonomy Name | Psychiatric Residential Treatment Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 324500000X
-----------------------------------------------------
Taxonomy Name | Substance Abuse Rehabilitation Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 283Q00000X
-----------------------------------------------------
Taxonomy Name | Psychiatric Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------