Provider Demographics
NPI:1003533019
Name:BLISSFUL HEALING LLC
Entity type:Organization
Organization Name:BLISSFUL HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMEKA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROUNDTREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-623-9096
Mailing Address - Street 1:4001 COLD HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6245
Mailing Address - Country:US
Mailing Address - Phone:919-623-9096
Mailing Address - Fax:
Practice Address - Street 1:900 BROADSTONE WAY STE 103
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-5013
Practice Address - Country:US
Practice Address - Phone:919-578-1994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2024-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty