# BLUME MATERNITY SUPPORT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619748639
- **Authorized official:** MS. JSHAUNTAE MARSHALL (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (702) 337-4793

## Contact information

- **Practice address:** 945 W CARSON ST APT 309, TORRANCE, CA 90502-2035
- **Practice address phone:** (702) 337-4793
- **Mailing address:** 8046 PAVAROTTI AVE, LAS VEGAS, NV 89178-8264
- **Mailing address phone:** (702) 337-4793

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QB0400X | Birthing Clinic/Center | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/09/2024
- **Last updated:** 01/09/2024