Provider Demographics
NPI:1386160562
Name:BLUEPRINT DEVELOPMENT CENTER
Entity type:Organization
Organization Name:BLUEPRINT DEVELOPMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:COMPHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-319-2019
Mailing Address - Street 1:5415 HARTWICK ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1518
Mailing Address - Country:US
Mailing Address - Phone:626-319-2019
Mailing Address - Fax:
Practice Address - Street 1:2501 SYCAMORE LN
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1518
Practice Address - Country:US
Practice Address - Phone:661-480-0742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities