# BLUEPRINT FOR SUCCESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BLUEPRINT FOR SUCCESS LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962001479
- **Authorized official:** MR. MICHAEL WARD (OWNER)
- **Authorized official phone:** (937) 723-0142

## Contact information

- **Practice address:** 117 E LIBERTY ST, SPRINGFIELD, OH 45505-1935
- **Practice address phone:** (937) 937-0142
- **Practice address fax:** (855) 300-5330
- **Mailing address:** 117 E LIBERTY ST, SPRINGFIELD, OH 45505-1935
- **Mailing address phone:** (937) 937-0142
- **Mailing address fax:** (855) 300-5330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | — |
| 103K00000X | Behavior Analyst | — | — | — |
| 174200000X | Meals Provider | — | NULL | — |
| 177F00000X | Lodging Provider | — | NULL | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |
| 261QM2800X | Methadone Clinic | — | NULL | — |
| 261QP2400X | Prison Health Clinic/Center | — | NULL | — |
| 261QR1100X | Research Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 10/26/2020
- **Last updated:** 10/26/2020