Provider Demographics
NPI:1366922593
Name:BLESSED BY BEAUTY HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:BLESSED BY BEAUTY HOME HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:MAC
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-339-4452
Mailing Address - Street 1:3111 S CEDAR CREST CT
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-1900
Mailing Address - Country:US
Mailing Address - Phone:314-339-4452
Mailing Address - Fax:
Practice Address - Street 1:3111 S CEDAR CREST CT
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1900
Practice Address - Country:US
Practice Address - Phone:816-239-1228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health