Organization
BLENDED AQUATICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREANNA MERHAR MA, BCBA (CO- FOUNDER/ BCBA)
(952) 212-0294
Entity
Organization
Contact information
Practice address
265 FEDERAL AVE APT 24, RAPID CITY, SD 57702-2463
(952) 212-0294
Mailing address
265 FEDERAL AVE APT 24, RAPID CITY, SD 57702-2463
(952) 212-0294
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/16/2022
Last updated
09/16/2022
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