MEDICARE: BLESSING HANDS HOME HEALTH 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	251E00000X	Home Health Agency	018751	TX

General Provider Information

NPI Number	:	1578059465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESSING HANDS HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	509 W TIDWELL RD STE 318
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-4355
Country	:	US
Telephone Number	:	281-240-1335
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 W TIDWELL RD STE 318
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-4355
Country	:	US
Telephone Number	:	281-240-1335
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. VAN D CARROLL
Credential	:	MSN RN
Telephone Number	:	281-240-0749

Provider Enumeration Date	:	07/03/2018
Last Update Date	:	07/03/2018

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