Provider Demographics
NPI:1407730062
Name:BLISS HOME HEALTHCARE
Entity type:Organization
Organization Name:BLISS HOME HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:
Authorized Official - Credentials:LALD
Authorized Official - Phone:612-836-9799
Mailing Address - Street 1:1901 STEVENS AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-3870
Mailing Address - Country:US
Mailing Address - Phone:612-836-9799
Mailing Address - Fax:
Practice Address - Street 1:5367 MINNEHAHA AVE APT 116
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2383
Practice Address - Country:US
Practice Address - Phone:612-836-9799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty