# BLESSFUL LAKE SENIOR CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275342677
- **Authorized official:** MR. ELLIS RAY JONES (MANAGING MEMBER)
- **Authorized official phone:** (760) 985-1583

## Contact information

- **Practice address:** 14460 HURRICANE LN, HELENDALE, CA 92342-7793
- **Practice address phone:** (760) 985-1583
- **Mailing address:** 16082 WATO RD, APPLE VALLEY, CA 92307-7810
- **Mailing address phone:** (760) 985-1583

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/01/2025
- **Last updated:** 01/01/2025