BLISSFULLY SUPPORTED LLC (NPI# 1255973210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255973210 |
| Entity Type | Organization |
| Organization Name | BLISSFULLY SUPPORTED LLC |
| Practice Address |
645 Dunbrook Ln Charlotte NC 28217-3405 |
| Practice Telephone | 9804749219 |
| Mailing Telephone | 9804749219 |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2019-10-11 |
| Authorized Official Name | ARTEECA ECCLES (OWNER) |
| Authorized Official Telephone | 9804749219 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
645 DUNBROOK LN |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28217-3405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962017798 | Kelby Rae Hurlocker | Specialist/Technologist | 500 Center Park Dr, Charlotte, NC 28217 | 2020-09-09 |
| 1356967749 | Optum Pharmacy 701, LLC | Pharmacy | 4015 Shopton Rd, Suite 600, Charlotte, NC 28217 | 2020-06-22 |
| 1598302937 | Brigit Boyce | Occupational Therapist | 8848 Red Oak Blvd, Ste Aa, Charlotte, NC 28217 | 2019-12-04 |
| 1275016933 | Zarah Pulfrey | Physician Assistant | Womack Medical Center, 2817 Riley Road, Fort Bragg, NC 28217 | 2018-09-10 |
| 1972085918 | Dynamic Health Medical Group Pllc | Pain Medicine | 4705 South Blvd, Charlotte, NC 28217 | 2018-09-06 |
| 1184102048 | Charday Caple | Counselor | 735 Echodale Dr, Charlotte, NC 28217 | 2018-08-02 |
| 1326532250 | Dupont Livery LLC | Non-emergency Medical Transport (VAN) | 4200 S Tryon St, Charlotte, NC 28217 | 2018-06-14 |
| 1891215232 | Lakesha Shamise Welch | Counselor | 5709 South Hampton R., Charlotte, NC 28217 | 2017-06-27 |
| 1245768282 | Allison Harris Lafone | Counselor | 515 Clanton Road, Charlotte, NC 28217 | 2017-06-02 |
| 1619416906 | Charlie Randolph Taylor Jr. | Counselor | 517 Clanton Road, Charlotte, NC 28217 | 2017-02-20 |
| Find all providers in zip 28217 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538767785 | Season of Change, Pllc | Clinic/Center | 933 Louise Ave # 407, Charlotte, NC 28204-2147 | 2020-10-10 |
| 1164038782 | B&g Counseling Services Pllc | Clinic/Center | 11220 Elm Ln Ste 200, Charlotte, NC 28277-0450 | 2020-09-18 |
| 1477166197 | Compass Counseling and Consulting LLC | Clinic/Center | 8411 Habersham Pointe Cir, Charlotte, NC 28226-4792 | 2020-08-24 |
| 1790340172 | Kolb Counseling Group Pllc | Clinic/Center | 6747 Fairview Rd Ste C, Charlotte, NC 28210-3359 | 2019-05-01 |
| 1316400088 | United Primary Diagnostic Center | Clinic/Center | 2103 N Graham St Ste B, Charlotte, NC 28206-2548 | 2019-04-10 |
| 1174093751 | Lineberger Christian Counseling, Pllc | Clinic/Center | 1811 Sardis Road North, Suite 207, Charlotte, NC 28270 | 2018-11-27 |
| 1396225348 | Real Talk Counseling | Clinic/Center | 2128 Mcclintock Rd, Charlotte, NC 28205-5114 | 2018-08-20 |
| 1811475569 | Art of Care Counseling | Clinic/Center | 6338 Shining Rock Ct, Charlotte, NC 28277-0118 | 2018-08-04 |
| 1891284675 | Ashakti Wellness & Yoga LLC | Clinic/Center | 1200 E Morehead St Ste 20d, Charlotte, NC 28204-2872 | 2018-05-07 |
| 1558860239 | Advanced Community Services LLC | Clinic/Center | 4700 Farm Pond Ln, Charlotte, NC 28212-8500 | 2018-02-07 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.