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General NPI Number Information
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NPI Number | 1316340961
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Entity Type | Organization
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Legal Business Name | BLESSED ASSURANCE HEAVENLY HOMECARE, LLC
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Dates
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Enumeration Date | 09/26/2014
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Last Update Date | 09/26/2014
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Provider Practice Location Address
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Address Line | 1481 ALMONT DR SW
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City | ATLANTA
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State | GA
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Zip | 30310-3756
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Country | US
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Telephone | 404-809-7646
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Fax |
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Provider Business Mailing Address
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Address Line | 1481 ALMONT DR SW
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City | ATLANTA
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State | GA
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Zip | 30310-3756
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Country | US
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Telephone | 404-809-7646
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KIMBERLY MORGAN
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Credential | RN, MSN
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Telephone | 404-809-7646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 166141
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License Number State | GA
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