Organization
CANLY BLESSED GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYDIA BOSUNGMEH ACHIRINDALLE (OWNER)
(405) 889-6273
Entity
Organization
Contact information
Practice address
26 SW 104TH ST, OKLAHOMA CITY, OK 73139-9040
(405) 889-6273
Mailing address
26 SW 104TH ST, OKLAHOMA CITY, OK 73139-9040
(405) 889-6273
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/19/2025
Last updated
08/19/2025
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