BLISS HAVEN, INC. (NPI# 1609435072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609435072 |
| Entity Type | Organization |
| Organization Name | BLISS HAVEN, INC. |
| Practice Address |
1304 Durham St Johnston City IL 62951-2043 |
| Mailing Address |
Po Box 502 Marion IL 62959-0502 |
| Practice Telephone | 6189520277 |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-06-10 |
| Authorized Official Name | MELISSA BITTLE (OWNER) |
| Authorized Official Telephone | 6189275300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
1304 DURHAM ST |
| City | JOHNSTON CITY |
| State | IL |
| Zip Code | 62951-2043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093230625 | Chrysalis Behavior Services | Behavioral Analyst | 13887 Jeffrey Mine Road, Johnston City, IL 62951 | 2017-08-04 |
| 1144454232 | Ashley Jean Byrley | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951 | 2009-05-05 |
| 1982888343 | Jamie Lynn Fred | Licensed Practical Nurse | 119 Gas Plant Road, Rea Clinic-duquoin, Johnston City, IL 62951 | 2007-12-20 |
| 1053593533 | Christopher Greater Area Rural Health Planning Corporation | Internal Medicine | 14410 Route 37, Johnston City Community Health Center, Johnston City, IL 62951 | 2007-11-27 |
| 1093166845 | Pathway House, Inc. | Assisted Living Facility | 806 W 10th St, Johnston City, IL 62951-1017 | 2016-06-23 |
| 1205907664 | Gary J Bandy | Pharmacist | 905 Grand Ave, Johnston City, IL 62951-1219 | 2006-11-09 |
| 1144355736 | Bandy Drugs | Pharmacy | 905 Grand Ave, Johnston City, IL 62951-1219 | 2007-02-22 |
| 1295020493 | Rachel Adrianne Pauls | Speech-Language Pathologist | 1108 Grand Ave, Johnston City, IL 62951-1229 | 2011-06-15 |
| 1962428516 | Johnston City Medical Clinic, S. C. | Clinic/Center | 201 W Broadway Blvd, Johnston City, IL 62951-1427 | 2006-07-15 |
| 1356342331 | Christa S Pestka | Family Medicine | 14410 Route 37, Johnston City, IL 62951-1427 | 2005-08-02 |
| Find all providers in zip 62951 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275131419 | Foatex Health Cilacare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 823 163rd St, Calumet City, IL 60409-5915 | 2020-10-10 |
| 1053949404 | A Great Place To Stay LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 35580 N Knowles Rd, Lake Villa, IL 60046-9026 | 2020-03-31 |
| 1255966602 | Infinicare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1939 Waukegan Rd Ste 300, Glenview, IL 60025-1758 | 2020-03-05 |
| 1023643772 | Supporting Community Independence | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1 Polo Grounds Ct, Bethalto, IL 62010-2623 | 2020-03-03 |
| 1770116287 | Universal Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12101 S La Salle St, Chicago, IL 60628-6618 | 2020-02-13 |
| 1760014625 | Tomeka R Morgan | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11543 S Ashland Ave, Chicago, IL 60643-5001 | 2020-02-10 |
| 1487292660 | Shalom Home Health Ltd | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8147 Seminole Ct, Orland Park, IL 60462-4919 | 2019-12-18 |
| 1447894613 | Compassionate Living Home Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2625 Butterfield Rd Ste 314e, Oak Brook, IL 60523-1234 | 2019-10-31 |
| 1417599945 | Miracle Comprehensive Serivces | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4440 Lincoln Hwy Ste 205, Matteson, IL 60443-3803 | 2019-10-16 |
| 1629531561 | Lashae Campbell | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3 Wildwood Lane G, Bolingbrook, IL 60440-1942 | 2019-04-08 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSTON CITY |
| Zip Code | 62951 |
Please comment or provide details below to improve the information on BLISS HAVEN, INC..
| 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.