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General NPI Number Information
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NPI Number | 1326836198
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Entity Type | Organization
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Legal Business Name | BLULIFE COMMUNITY HEALTH LLC
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 108 S BODDIE ST
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City | NASHVILLE
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State | NC
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Zip | 27856-1220
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Country | US
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Telephone | 252-915-6654
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Fax |
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Provider Business Mailing Address
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Address Line | 502 FORD CIR
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City | LOUISBURG
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State | NC
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Zip | 27549-2230
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASSANDRA DAVIS
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Credential |
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Telephone | 252-915-6654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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