Provider Demographics
NPI:1225489701
Name:A BLISSFUL HAVEN AFH LLC
Entity Type:Organization
Organization Name:A BLISSFUL HAVEN AFH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:OLAMIDE
Authorized Official - Middle Name:ADETORO
Authorized Official - Last Name:ADEWALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-230-2384
Mailing Address - Street 1:3031 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-1339
Mailing Address - Country:US
Mailing Address - Phone:509-230-2384
Mailing Address - Fax:509-838-7873
Practice Address - Street 1:3031 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-1339
Practice Address - Country:US
Practice Address - Phone:509-230-2384
Practice Address - Fax:509-838-7873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN600034807163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty