Blessed Support Professionals, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

BLESSED SUPPORT PROFESSIONALS, INC

Practice address

14511 Jefferson Davis Hwy # a
Woodbridge, VA 22191-2807

Phone

(703) 494-6014

NPI assigned

May 14, 2019

Organization subpart

No

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

Authorized official

Name

Ebenezer Banahene

Title

President

Phone

(703) 926-9739

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557792000000",
    "number": "1831755958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14511 JEFFERSON DAVIS HWY # A",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221912807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14511 JEFFERSON DAVIS HWY # A",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221912807",
            "telephone_number": "703-494-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLESSED SUPPORT PROFESSIONALS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-14",
        "last_updated": "2019-05-14",
        "status": "A",
        "authorized_official_last_name": "BANAHENE",
        "authorized_official_first_name": "EBENEZER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-926-9739"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; 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.