Canly Blessed Group Home LLC
NPI #1043197296 in Oklahoma City, Oklahoma
Provider Information
- NPI Number
- 1043197296
- Entity Type
- Organization
- Organization Name
- Canly Blessed Group Home LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Aug 19, 2025
- Last Updated
- Aug 19, 2025
Practice Location
- Address
- 26 SW 104TH ST
- City
- Oklahoma City
- State
- Oklahoma
- ZIP Code
- 73139-9040
- Phone
- (405) 889-6273
Authorized Official
- Name
- MS. LYDIA BOSUNGMEH ACHIRINDALLE
- Title
- OWNER
- Phone
- (405) 889-6273
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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