Provider Demographics
NPI:1013669688
Name:BLISS MENTAL WELLNESS
Entity Type:Organization
Organization Name:BLISS MENTAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SEINAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAACS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:952-564-9363
Mailing Address - Street 1:2503 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-2080
Mailing Address - Country:US
Mailing Address - Phone:952-564-9363
Mailing Address - Fax:
Practice Address - Street 1:2503 11TH AVE
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2080
Practice Address - Country:US
Practice Address - Phone:952-564-9363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)