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General NPI Number Information
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NPI Number | 1760682017
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Entity Type | Organization
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Legal Business Name | MIXED BLESSINGS, LLC.
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 7811 BLAZING GAP
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City | MISSOURI CITY
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State | TX
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Zip | 77459-6037
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Country | US
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Telephone | 281-778-9587
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Fax | 281-778-9587
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Provider Business Mailing Address
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Address Line | 7811 BLAZING GAP
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City | MISSOURI CITY
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State | TX
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Zip | 77459-6037
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Country | US
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Telephone | 281-778-9587
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Fax | 281-778-9587
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Authorized Official
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Title or Position | PRESIDENT/CFO
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Name | MR. MARIO BALIAO ILANGA
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Credential |
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Telephone | 281-778-9587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | UNDER PROCESS
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License Number State | TX
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