Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pastoral |
101YP1600X | |||
Community Health |
261QC1500X | |||
Community/Behavioral Health |
251S00000X | |||
Counselor |
101Y00000X | |||
Day Training, Developmentally Disabled Services |
251C00000X | |||
Health Service |
261QH0100X | |||
In Home Supportive Care |
253Z00000X | |||
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice | |
VA |
261QV0200X |
| NPI # | 1700622453 |
| LBN Legal business name | BLYTHE PROJECT LLC |
| Authorized official | DENNIS MATTHEWS - (MANAGER PARTNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/02/2024 |
| Last updated | 07/02/2024 - More than a year ago |
| Identifiers | n/a |
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