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General NPI Number Information
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NPI Number | 1861023905
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Entity Type | Organization
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Legal Business Name | BLUEPRINTS THERAPEUTIC SERVICES LLC
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 1113 E GURLEY ST
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City | PRESCOTT
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State | AZ
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Zip | 86301-3309
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Country | US
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Telephone | 928-583-4878
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10878
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City | PRESCOTT
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State | AZ
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Zip | 86304-0878
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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 | CEO
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Name | MR. KEVIN ROSS
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Credential |
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Telephone | 917-903-7445
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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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