Provider Demographics
NPI:1659082790
Name:THE PARENTAL BLUEPRINT
Entity Type:Organization
Organization Name:THE PARENTAL BLUEPRINT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAHIRAH
Authorized Official - Middle Name:VIOLA
Authorized Official - Last Name:SUMBRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-733-2664
Mailing Address - Street 1:1227 N PEACHTREE PKWY STE 162
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1743
Mailing Address - Country:US
Mailing Address - Phone:770-733-2664
Mailing Address - Fax:
Practice Address - Street 1:41 COPELAND ST
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3132
Practice Address - Country:US
Practice Address - Phone:770-733-2664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-09
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management