MEDICARE: BLESSED HEALTHCARE SERVICES OF GEORGIA, 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

General Provider Information

NPI Number	:	1851985881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESSED HEALTHCARE SERVICES OF GEORGIA, LLC

Provider Business Mailing Address
First Line	:	5745 WENDY BAGWELL PKWY STE 22
Second Line	:
City	:	HIRAM
State	:	GA
Zip	:	30141-2885
Country	:	US
Telephone Number	:	404-932-7788
Fax Number	:

Provider Business Practice Location Address
First Line	:	5745 WENDY BAGWELL PKWY STE 22
Second Line	:
City	:	HIRAM
State	:	GA
Zip	:	30141-2885
Country	:	US
Telephone Number	:	404-932-7788
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	OBIJURU S OKEZIE
Credential	:
Telephone Number	:	404-932-7788

Provider Enumeration Date	:	02/20/2021
Last Update Date	:	02/20/2021

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