Provider Demographics
NPI:1033978671
Name:BLISSFUL BREEZE LLC
Entity Type:Organization
Organization Name:BLISSFUL BREEZE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SALMA
Authorized Official - Middle Name:
Authorized Official - Last Name:JARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-360-2086
Mailing Address - Street 1:5245 VILLAGE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3171
Mailing Address - Country:US
Mailing Address - Phone:713-360-2086
Mailing Address - Fax:
Practice Address - Street 1:5245 VILLAGE VIEW LN
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3171
Practice Address - Country:US
Practice Address - Phone:713-360-2086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies