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General NPI Number Information
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NPI Number | 1306334750
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Entity Type | Individual
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Provider Name | MS. BLESSING O EYA
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Gender | Female
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Dates
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Enumeration Date | 05/01/2018
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Last Update Date | 05/01/2018
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Provider Practice Location Address
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Address Line | 5312 MORNING DOVE LN
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City | CHARLESTON
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State | WV
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Zip | 25313-1154
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Country | US
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Telephone | 304-444-5179
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Fax |
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Provider Business Mailing Address
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Address Line | 5314 STEPHEN WAY
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City | CROSS LANES
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State | WV
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Zip | 25313-1159
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Country | US
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Telephone | 304-444-5179
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Fax | 681-217-1282
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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