MEDICARE: BLESSED STAR HOME HEALTH SERVICES, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251F00000X	Home Infusion Agency
2	251J00000X	Nursing Care Agency
3	253J00000X	Foster Care Agency
4	253Z00000X	In Home Supportive Care Agency
5	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1538672639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESSED STAR HOME HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	12629 KEITHA ADAMS DR
Second Line	:
City	:	HORIZON CITY
State	:	TX
Zip	:	79928-7515
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12629 KEITHA ADAMS DR
Second Line	:
City	:	HORIZON CITY
State	:	TX
Zip	:	79928-7515
Country	:	US
Telephone Number	:	915-234-7280
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	LUCY CHEGE
Credential	:
Telephone Number	:	915-234-7280

Provider Enumeration Date	:	11/10/2017
Last Update Date	:	11/10/2017

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