Healthcare Provider Details

I. General information

NPI: 1922812957
Provider Name (Legal Business Name): BLARRITA DELIGHTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 THOMAS ST STE 140
WORCESTER MA
01608-1235
US

IV. Provider business mailing address

24 JASMINE DR
WORCESTER MA
01605-1099
US

V. Phone/Fax

Practice location:
  • Phone: 508-832-8478
  • Fax: 508-792-0478
Mailing address:
  • Phone: 508-762-6571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. LARRY BROWN
Title or Position: CEO
Credential: CPA
Phone: 508-762-6571