Provider Demographics
NPI:1104449099
Name:BLESSED HANDS MOBILE HEALTHCARE
Entity type:Organization
Organization Name:BLESSED HANDS MOBILE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:G
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-681-4682
Mailing Address - Street 1:5620 SW GREEN OAKS BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-1151
Mailing Address - Country:US
Mailing Address - Phone:817-681-4682
Mailing Address - Fax:
Practice Address - Street 1:5620 SW GREEN OAKS BLVD STE C
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1151
Practice Address - Country:US
Practice Address - Phone:817-681-4682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty