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Contact Information

BLACK MOUNTAIN BLESSING LLC
706 E BELL RD STE 120
PHOENIX, AZ85022-6655
 Phone: 602-362-3317
 Fax: 602-344-9043
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

In Home Supportive Care

253Z00000X
Indicates primary specialty

NPI Profile & details for BLACK MOUNTAIN BLESSING LLC

NPI Number 1144715087
LBN Legal business name BLACK MOUNTAIN BLESSING LLC
Authorized official AARON STOUGH - (OWNER/MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/23/2018
Last updated 06/23/2018 - About 8 years ago
Identifiers
AZ License # 288318
AZ Medicaid 288318
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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