MEDICARE: BLESSED HANDS HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1205799053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESSED HANDS HOMECARE LLC

Provider Business Mailing Address
First Line	:	4200 S WASHINGTON ST APT 101
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58201-5571
Country	:	US
Telephone Number	:	701-410-8711
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 S WASHINGTON ST APT 101
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58201-5571
Country	:	US
Telephone Number	:	701-410-8711
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BLESSING MAIKOTI
Credential	:
Telephone Number	:	701-410-8711

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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