Healthcare Provider Details

I. General information

NPI: 1861234098
Provider Name (Legal Business Name): BRAIN BLISS MANAGEMENT COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2024
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 TURNER ST
LANSING MI
48906-4344
US

IV. Provider business mailing address

1410 TURNER ST
LANSING MI
48906-4344
US

V. Phone/Fax

Practice location:
  • Phone: 517-615-1527
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: BILLIE FOLEY
Title or Position: OWNER
Credential:
Phone: 517-615-1527