Organization
BLESSED HEALTH CARE PROVIDER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELINA PINEDA (PRESIDENT)
(909) 392-8917
Entity
Organization
Contact information
Practice address
1768 ARROW HWY STE 103, LA VERNE, CA 91750-5335
(626) 858-2319
(626) 858-8355
Mailing address
1768 ARROW HWY STE 103, LA VERNE, CA 91750-5335
(626) 858-2319
(626) 858-8355
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D1070865
CLIA CERT OF WAIVER
—
Enumeration date
09/26/2007
Last updated
05/20/2025
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