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General NPI Number Information
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NPI Number | 1275786436
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Entity Type | Organization
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Legal Business Name | BLESSED ASSURANCE HOME CARE LLC
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Dates
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Enumeration Date | 10/30/2008
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Last Update Date | 10/30/2008
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Provider Practice Location Address
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Address Line | 2400 ROBINSON RD
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City | LANSING
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State | MI
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Zip | 48910-4860
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Country | US
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Telephone | 517-393-9201
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Fax | 517-393-5547
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Provider Business Mailing Address
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Address Line | PO BOX 27302
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City | LANSING
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State | MI
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Zip | 48909-7302
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Country | US
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Telephone | 517-393-9201
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Fax | 517-393-5547
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MS. MARSHA JEANETTE PAGE
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Credential | LPN
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Telephone | 517-393-9201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 4703061419
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License Number State | MI
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