Provider Demographics
NPI:1477948354
Name:BLISS ADULT DAY CARE
Entity Type:Organization
Organization Name:BLISS ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTIAL OWNER/ DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:AMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-639-7222
Mailing Address - Street 1:203 N PROVIDENCE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4189
Mailing Address - Country:US
Mailing Address - Phone:573-639-7222
Mailing Address - Fax:
Practice Address - Street 1:203 N PROVIDENCE RD STE 201
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4189
Practice Address - Country:US
Practice Address - Phone:573-639-7222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1233261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care