Provider Demographics
NPI:1699510594
Name:BLISSFUL HOME HEALTH CARE STAFFING AGENCY LLC
Entity type:Organization
Organization Name:BLISSFUL HOME HEALTH CARE STAFFING AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MONONO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-834-5456
Mailing Address - Street 1:8066 CORA CT
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-3932
Mailing Address - Country:US
Mailing Address - Phone:440-624-3049
Mailing Address - Fax:
Practice Address - Street 1:8066 CORA CT
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-3932
Practice Address - Country:US
Practice Address - Phone:440-624-3049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health