Provider Demographics
NPI:1306261581
Name:BLISSFUL HOMECARE LLC
Entity type:Organization
Organization Name:BLISSFUL HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:WATIRI
Authorized Official - Last Name:MAINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-725-5505
Mailing Address - Street 1:90 SUTTON ST STE 4
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-1655
Mailing Address - Country:US
Mailing Address - Phone:978-725-5505
Mailing Address - Fax:
Practice Address - Street 1:90 SUTTON ST STE 4
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1655
Practice Address - Country:US
Practice Address - Phone:978-725-5505
Practice Address - Fax:978-416-9574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110101701AMedicaid
MA110101701AMedicaid