Provider Demographics
NPI:1316743701
Name:BLISS CENTER INC
Entity type:Organization
Organization Name:BLISS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-835-2878
Mailing Address - Street 1:7900 SE LUTHER RD APT 1202
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-9274
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1429 SE 122ND AVE # 1441H
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-1204
Practice Address - Country:US
Practice Address - Phone:909-835-2878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services