MEDICARE: BE BLESSED ADULT CARE SERVICE

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	:	1952665507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BE BLESSED ADULT CARE SERVICE

Provider Business Mailing Address
First Line	:	10262 PAGE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-1322
Country	:	US
Telephone Number	:	314-496-3848
Fax Number	:	314-395-9655

Provider Business Practice Location Address
First Line	:	10262 PAGE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-1322
Country	:	US
Telephone Number	:	314-496-3848
Fax Number	:	314-395-9655

Authorized Official
Title or Position	:	OWNER
Name	:	MS. TONIA DENISE AMBUS
Credential	:
Telephone Number	:	314-496-3848

Provider Enumeration Date	:	06/28/2012
Last Update Date	:	06/28/2012

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Directions to “BE BLESSED ADULT CARE SERVICE ” Practice Location

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