Provider Demographics
NPI:1679606198
Name:MISS B'S BLESSINGS
Entity type:Organization
Organization Name:MISS B'S BLESSINGS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSILAND
Authorized Official - Middle Name:R
Authorized Official - Last Name:SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-533-1922
Mailing Address - Street 1:4739 COTE BRILLIANTE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63113
Mailing Address - Country:US
Mailing Address - Phone:314-533-1922
Mailing Address - Fax:314-533-1393
Practice Address - Street 1:4739 COTE BRILLIANTE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63113
Practice Address - Country:US
Practice Address - Phone:314-533-1922
Practice Address - Fax:314-533-1393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO033336311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO267643807Medicaid