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General NPI Number Information
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NPI Number | 1811404643
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Entity Type | Organization
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Legal Business Name | BLESSIN ANGEL HOME CARE LLC
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Dates
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Enumeration Date | 01/02/2018
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Last Update Date | 01/02/2018
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Provider Practice Location Address
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Address Line | 9006 S ANTHONY AVE
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City | CHICAGO
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State | IL
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Zip | 60617-4147
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Country | US
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Telephone | 773-563-2299
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Fax |
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Provider Business Mailing Address
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Address Line | 9006 S ANTHONY AVE
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City | CHICAGO
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State | IL
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Zip | 60617-4147
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Country | US
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Telephone | 773-563-2299
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Fax |
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Authorized Official
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Title or Position | AGANCY MANAGER
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Name | THERESA BLACKMAN
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Credential |
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Telephone | 773-563-2299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 3001330
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License Number State | IL
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