A Blessed Home LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

A BLESSED HOME LLC

Doing business as

Blessed Home - A Summerlin Retirement Home

Practice address

309 La Rue CT
Las Vegas, NV 89145-4170

Phone

(702) 683-9883

Fax

(702) 333-1124

NPI assigned

Nov 2, 2022

Last updated

Nov 2, 2022By 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

Rosallen Mercado Azucena

Title

Managing Member

Phone

(702) 683-9883

Specialties & licenses 1

Addresses

Other names 1

• Blessed Home - A Summerlin Retirement Home Doing business as

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1679280325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 LA RUE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891454170",
            "telephone_number": "702-683-9883",
            "fax_number": "702-333-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 LA RUE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891454170",
            "telephone_number": "702-683-9883",
            "fax_number": "702-333-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BLESSED HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "AZUCENA",
        "authorized_official_first_name": "ROSALLEN",
        "authorized_official_middle_name": "MERCADO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "702-683-9883"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blessed Home - A Summerlin Retirement Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.