Black Mountain Blessing LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

288318 Issued in AZ

Legal business name

BLACK MOUNTAIN BLESSING LLC

Doing business as

Home Instead Senior Care

Practice address

706 E Bell Rd Ste 120
Phoenix, AZ 85022-6655

Phone

(602) 362-3317

Fax

(602) 344-9043

NPI assigned

Jun 23, 2018

Last updated

Jun 23, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Aaron Robert Stough

Title

Owner/Member

Phone

(602) 362-3317

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Home Instead Senior Care Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529712000000",
    "number": "1144715087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 E BELL RD STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850226655",
            "telephone_number": "602-362-3317",
            "fax_number": "602-344-9043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 E BELL RD STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850226655",
            "telephone_number": "602-362-3317",
            "fax_number": "602-344-9043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK MOUNTAIN BLESSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-23",
        "last_updated": "2018-06-23",
        "status": "A",
        "authorized_official_last_name": "STOUGH",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "602-362-3317"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "AZ",
            "license": "288318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288318",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Instead Senior Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• David Black, O.D.
• Delbert Roger Black, MD
• Evelyn Black
• Farrah L Black, PA
• Karen Black

• In Home Supportive Care Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• In Home Supportive Care Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.