Organization
BLESSED HAVEN INDEPENDENT LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRIANA SANTAN LEWIS (OWNER)
(769) 204-0494
Entity
Organization
Contact information
Practice address
306 BEECH ST, MCCOMB, MS 39648-5064
(769) 204-0494
Mailing address
306 BEECH ST, MCCOMB, MS 39648-5064
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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