Provider Demographics
NPI:1992302061
Name:BLESSINGS IN DISGUISE LLC
Entity type:Organization
Organization Name:BLESSINGS IN DISGUISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KADEIDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-696-1891
Mailing Address - Street 1:18709 ALBION ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-3701
Mailing Address - Country:US
Mailing Address - Phone:586-696-1891
Mailing Address - Fax:
Practice Address - Street 1:52 23RD ST S
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-2706
Practice Address - Country:US
Practice Address - Phone:586-696-1891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care