Provider Demographics
NPI:1487901138
Name:BLESSED HANDS PRIVATE CARE
Entity type:Organization
Organization Name:BLESSED HANDS PRIVATE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEYMA
Authorized Official - Middle Name:KENYATTA
Authorized Official - Last Name:TOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-609-8427
Mailing Address - Street 1:1544 WELLBORN RD.374
Mailing Address - Street 2:
Mailing Address - City:REDAN
Mailing Address - State:GA
Mailing Address - Zip Code:30074
Mailing Address - Country:US
Mailing Address - Phone:770-609-8427
Mailing Address - Fax:770-609-8427
Practice Address - Street 1:1544 WELLBORN RD.374
Practice Address - Street 2:
Practice Address - City:REDAN
Practice Address - State:GA
Practice Address - Zip Code:30074
Practice Address - Country:US
Practice Address - Phone:770-609-8427
Practice Address - Fax:770-609-8427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056926271347C00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle