Provider Demographics
NPI:1952190621
Name:BLISSFUL HAVEN LLC
Entity type:Organization
Organization Name:BLISSFUL HAVEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KEHINDE
Authorized Official - Middle Name:AYODEJI
Authorized Official - Last Name:OLADAPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-215-9615
Mailing Address - Street 1:18722 SNOWY PLOVER CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-6130
Mailing Address - Country:US
Mailing Address - Phone:202-215-9615
Mailing Address - Fax:
Practice Address - Street 1:1420 E 27TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3920
Practice Address - Country:US
Practice Address - Phone:202-215-9615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances