Provider Demographics
NPI:1568274736
Name:BIANCA'S BLANK CANVASES
Entity type:Organization
Organization Name:BIANCA'S BLANK CANVASES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-978-1519
Mailing Address - Street 1:20790 DEXTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-3404
Mailing Address - Country:US
Mailing Address - Phone:313-978-1519
Mailing Address - Fax:
Practice Address - Street 1:20790 DEXTER BLVD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-3404
Practice Address - Country:US
Practice Address - Phone:313-978-1519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care