Provider Demographics
NPI:1760682017
Name:MIXED BLESSINGS, LLC.
Entity type:Organization
Organization Name:MIXED BLESSINGS, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:BALIAO
Authorized Official - Last Name:ILANGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-778-9587
Mailing Address - Street 1:7811 BLAZING GAP
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6037
Mailing Address - Country:US
Mailing Address - Phone:281-778-9587
Mailing Address - Fax:281-778-9587
Practice Address - Street 1:7811 BLAZING GAP
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6037
Practice Address - Country:US
Practice Address - Phone:281-778-9587
Practice Address - Fax:281-778-9587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXUNDER PROCESS251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health