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General NPI Number Information
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NPI Number | 1598462830
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Entity Type | Organization
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Legal Business Name | BLESSING SSUBI LLC
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 12429 W MIDWAY AVE
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City | GLENDALE
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State | AZ
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Zip | 85307-1833
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Country | US
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Telephone | 818-942-4603
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Fax |
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Provider Business Mailing Address
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Address Line | 5410 QUAKERTOWN AVE APT 107
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2523
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Country | US
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Telephone | 818-942-4603
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MISS NELLY NAMUGAMBE
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Credential |
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Telephone | 818-942-4603
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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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