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General NPI Number Information
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NPI Number | 1386160562
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Entity Type | Organization
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Legal Business Name | BLUEPRINT DEVELOPMENT CENTER
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 08/18/2017
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Provider Practice Location Address
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Address Line | 2501 SYCAMORE LN
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City | PALMDALE
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State | CA
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Zip | 93551-1518
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Country | US
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Telephone | 661-480-0742
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Fax |
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Provider Business Mailing Address
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Address Line | 5415 HARTWICK ST
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City | LOS ANGELES
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State | CA
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Zip | 90041-1518
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Country | US
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Telephone | 626-319-2019
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Fax |
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Authorized Official
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Title or Position | FINANCIAL OFFICER
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Name | MR. ALBERT EDWIN COMPHER
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Credential |
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Telephone | 626-319-2019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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