Provider Demographics
NPI:1427678515
Name:BLESSED WITH GOODNESS, LLC
Entity type:Organization
Organization Name:BLESSED WITH GOODNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:
Authorized Official - First Name:TOSHIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-246-8003
Mailing Address - Street 1:716 E FAIRFIELD RD STE 120
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-3688
Mailing Address - Country:US
Mailing Address - Phone:864-558-0044
Mailing Address - Fax:
Practice Address - Street 1:1811 SARDIS RD N STE 207
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-3000
Practice Address - Country:US
Practice Address - Phone:704-246-8003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLESSED WITH GOODNESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-20
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care