Organization
BLISSFULLY SUPPORTED ENTERPRISES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KADEJIA MUNGO (OWNER)
(704) 526-6407
Entity
Organization
Contact information
Practice address
714 MONTANA DR STE J, CHARLOTTE, NC 28216-0076
(704) 526-6407
Mailing address
714 MONTANA DR STE J, CHARLOTTE, NC 28216-0076
(704) 526-6407
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
310400000X
Assisted Living Facility
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
09/24/2024
Last updated
09/24/2024
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