Provider Demographics
NPI:1346066875
Name:BLISSFUL CARE ALLIANCE, LLC.
Entity type:Organization
Organization Name:BLISSFUL CARE ALLIANCE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA-CLEO
Authorized Official - Middle Name:
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-690-1999
Mailing Address - Street 1:18310 MONTGOMERY VILLAGE AVE
Mailing Address - Street 2:SUITE 300 #1115
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879
Mailing Address - Country:US
Mailing Address - Phone:240-283-5541
Mailing Address - Fax:
Practice Address - Street 1:503 MAIN ST APT 327
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-6459
Practice Address - Country:US
Practice Address - Phone:240-690-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-30
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No332U00000XSuppliersHome Delivered Meals
No376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child