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General NPI Number Information
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NPI Number | 1285493262
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Entity Type | Organization
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Legal Business Name | BLISS MENTAL HEALTH CLINIC LLC
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Dates
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Enumeration Date | 03/13/2024
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 6128 LANDOVER RD
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City | CHEVERLY
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State | MD
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Zip | 20785-1016
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Country | US
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Telephone | 202-699-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 1160 VARNUM ST NE STE 213
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City | WASHINGTON
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State | DC
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Zip | 20017-2106
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Country | US
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Telephone | 202-699-5577
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Fax |
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Authorized Official
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Title or Position | OWNER OF ENTITY
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Name | UKAMAKA OKEKE
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Credential | MSN, CNP
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Telephone | 202-699-5577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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