Provider Demographics
NPI:1922579986
Name:BAMBI'S BLISS LLC
Entity Type:Organization
Organization Name:BAMBI'S BLISS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:DANIELLE NICOLE
Authorized Official - Last Name:WILLS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:317-658-5677
Mailing Address - Street 1:1946 N LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-4572
Mailing Address - Country:US
Mailing Address - Phone:317-658-5677
Mailing Address - Fax:
Practice Address - Street 1:1060 N CAPITOL AVE STE E290
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1081
Practice Address - Country:US
Practice Address - Phone:317-762-6058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty