Provider Demographics
NPI:1427532209
Name:BLESSED FAMILY HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:BLESSED FAMILY HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROOSEVELT
Authorized Official - Middle Name:
Authorized Official - Last Name:DORCELUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-362-6828
Mailing Address - Street 1:4100 EVANS AVE STE 24
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9368
Mailing Address - Country:US
Mailing Address - Phone:239-362-6828
Mailing Address - Fax:
Practice Address - Street 1:4100 EVANS AVE STE 24
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9368
Practice Address - Country:US
Practice Address - Phone:239-362-6828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care