Provider Demographics
NPI:1487052742
Name:BLESSINGS BEYOND
Entity type:Organization
Organization Name:BLESSINGS BEYOND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:LATRICE
Authorized Official - Last Name:MAYES
Authorized Official - Suffix:
Authorized Official - Credentials:MBCS
Authorized Official - Phone:601-573-4515
Mailing Address - Street 1:PO BOX 1993
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39215-1993
Mailing Address - Country:US
Mailing Address - Phone:769-524-7848
Mailing Address - Fax:601-510-9364
Practice Address - Street 1:327 LIVINGSTON ST
Practice Address - Street 2:A
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-1525
Practice Address - Country:US
Practice Address - Phone:769-524-7848
Practice Address - Fax:601-510-9364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS44780251J00000X, 385H00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health