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NPI 1558807743

NPI 1558807743 : BLESSING HEARTS HEALTHCARE SERVICES,LLC : TYLERTOWN, MS

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General NPI Number Information
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    NPI Number           |    1558807743
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    Entity Type          |    Organization 
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    Legal Business Name  |    BLESSING HEARTS HEALTHCARE SERVICES,LLC 
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Dates
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    Enumeration Date     |    01/11/2017
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    Last Update Date     |    01/23/2017
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Provider Practice Location Address
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    Address Line         |    105 NORTH CHERRY ST. 
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    City                 |    TYLERTOWN
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    State                |    MS
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    Zip                  |    39667-7533
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    Country              |    US
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    Telephone            |    601-814-0060
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    105 NORTH CHERRY ST. 
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    City                 |    TYLERTOWN
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    State                |    MS
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    Zip                  |    39667-7533
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    Country              |    US
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    Telephone            |    601-814-9256
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     NUTRECIA  THOMPSON 
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    Credential           |    
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    Telephone            |    601-814-0060
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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       |    319249
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    License Number State |    MS
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Taxonomy #2
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    Taxonomy Code        |    253Z00000X
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    Taxonomy Name        |    In Home Supportive Care Agency
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    License Number       |    
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    License Number State |    
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