Provider Demographics
NPI:1629788047
Name:BLUE BLANKET LEARNING CENTER LLC
Entity Type:Organization
Organization Name:BLUE BLANKET LEARNING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EDUCATIONAL COACH
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-206-7694
Mailing Address - Street 1:2688 LILYPARK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-5543
Mailing Address - Country:US
Mailing Address - Phone:614-206-7694
Mailing Address - Fax:
Practice Address - Street 1:2688 LILYPARK DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-5543
Practice Address - Country:US
Practice Address - Phone:614-206-7694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty