Organization
BLISSFULLY SUPPORTED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARTEECA ECCLES (OWNER)
(980) 474-9219
Entity
Organization
Contact information
Practice address
645 DUNBROOK LN, CHARLOTTE, NC 28217-3405
(980) 474-9219
Mailing address
645 DUNBROOK LN, CHARLOTTE, NC 28217-3405
(980) 474-9219
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
10/11/2019
Last updated
10/11/2019
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