Provider Demographics
NPI:1639435027
Name:FOLLOW YOUR BLISS ENDEAVORS LLC
Entity Type:Organization
Organization Name:FOLLOW YOUR BLISS ENDEAVORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:RABKA
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-306-9522
Mailing Address - Street 1:PO BOX 1691
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-1691
Mailing Address - Country:US
Mailing Address - Phone:505-306-9522
Mailing Address - Fax:
Practice Address - Street 1:3505 CALLE CUERVO NW
Practice Address - Street 2:#338
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-9244
Practice Address - Country:US
Practice Address - Phone:505-306-9522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0076941251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health