Provider Demographics
NPI:1487429684
Name:BLESSED ASSURANCE HOME CARE
Entity type:Organization
Organization Name:BLESSED ASSURANCE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:334-235-7319
Mailing Address - Street 1:2244 S SUTHERLAND DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2137
Mailing Address - Country:US
Mailing Address - Phone:334-231-9306
Mailing Address - Fax:
Practice Address - Street 1:2244 S SUTHERLAND DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2137
Practice Address - Country:US
Practice Address - Phone:334-231-9306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care