Provider Demographics
NPI:1932928033
Name:BLESSED BEHAVIOR LLC
Entity type:Organization
Organization Name:BLESSED BEHAVIOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:714-576-8898
Mailing Address - Street 1:2522 CHAMBERS RD STE 219
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6962
Mailing Address - Country:US
Mailing Address - Phone:714-552-4725
Mailing Address - Fax:949-264-9490
Practice Address - Street 1:2522 CHAMBERS ROAD
Practice Address - Street 2:SUITE 219
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2702
Practice Address - Country:US
Practice Address - Phone:714-552-4725
Practice Address - Fax:949-264-9490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health