Organization
BLISSETT HEALTH SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATWANYA MONIQUE BLISSETT (CEO)
(229) 548-9774
Entity
Organization
Contact information
Practice address
3490 LENOX DR, VALDOSTA, GA 31605-7433
(229) 548-9774
Mailing address
PO BOX 4031, VALDOSTA, GA 31604-4031
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
GA
251E00000X
Home Health Agency
—
GA
332B00000X
Durable Medical Equipment & Medical Supplies
—
GA
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
07/12/2016
Last updated
08/18/2016
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