Provider Demographics
NPI:1861160467
Name:BLESSED BEYOND EXPECTATIONS LLC
Entity type:Organization
Organization Name:BLESSED BEYOND EXPECTATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEACH-TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-205-0909
Mailing Address - Street 1:2801 CRISMAN ST STE 103-A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-3847
Mailing Address - Country:US
Mailing Address - Phone:980-309-0577
Mailing Address - Fax:980-309-0597
Practice Address - Street 1:2801 CRISMAN ST STE 103-A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-3847
Practice Address - Country:US
Practice Address - Phone:980-309-0577
Practice Address - Fax:980-309-0597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care