Provider Demographics
NPI:1386382471
Name:BLESSED L HOME CARE LLC
Entity type:Organization
Organization Name:BLESSED L HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BIENVENIDO
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLOBAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-703-6476
Mailing Address - Street 1:2524 E ROESER RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85040-3626
Mailing Address - Country:US
Mailing Address - Phone:602-703-6476
Mailing Address - Fax:
Practice Address - Street 1:2524 E ROESER RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-3626
Practice Address - Country:US
Practice Address - Phone:602-703-6476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No174200000XOther Service ProvidersMealsGroup - Multi-Specialty
No177F00000XOther Service ProvidersLodging
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit