=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992477152
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLESSING HANDS COMPANION SERVICE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2021
-----------------------------------------------------
Last Update Date | 10/09/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 614 W WRIGHT ST
-----------------------------------------------------
City | PENSACOLA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32501-4757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 185-035-6023
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 614 W WRIGHT ST
-----------------------------------------------------
City | PENSACOLA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32501-4757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-356-0230
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MISS DOMINIQUE TIARA MURPHY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 850-356-0230
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 385H00000X
-----------------------------------------------------
Taxonomy Name | Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------